Selective Immunoglobulin A deficiency is a commonest form of primary immunodeficiency. It is a genetic disorder and it is more commonly present in Europeans than people of other countries. The deficiency can be defined when the immunoglobulin A (IgA) is absent in the body. Around 1 in 900 is affected with the disease.
Immunoglobulin A is an anti body which protects us from the infections of the mucous membrane lining of the intestine, respiratory tract, tonsils, sinuses and mouth. Its absence may cause mild gastrointestinal and respiratory tract infections. Such individuals are also susceptible to suffer from autoimmune diseases.
There are normal B cells in the peripheral blood in immunoglobulin A deficiency, but this B lymphocytes do not mature to produce immunoglobulin A for some reason, and thus it gives rise to immunoglobulin A deficiency.
Causes Of Immunoglobulin A Deficiency
It is an inherited disease. However, it can also be caused by many drugs. Discontinuing these drugs will resolve the condition. Some of the drugs involved in immunoglobulin a deficiency are: NSAIDs, phenytoin, carbamezapine, sulphasalazine, D-penicillamine, valporic acid, levamizole, salicylic acid, fenclofenac etc.
Certain infections can also cause temporary IgA deficiency; these infections are Rubella, cytomegalovirus, toxoplasma gondii, E-B virus.
Immunoglobulin A Deficiency Symptoms
Most of the times there is no manifestation of any symptoms. This is because of presence of other types of immunoglobulin IgG and IgM in sufficient amount. But when they occur there are recurrent episodes of:
- Bronchitis
- Diarrhea
- Sinusitis
- Mouth infection
- Recurrent tonsillitis
- Hepatitis
- Cholelitialsis
- Skin infection
- Otitis media
- Asthma
- Eye infection
- Giardiasis
- Purpura
- Rhinitis
- Urticaria
- Chronic nephritis
- Milk intolerance
- Cramps after eating
- Recurrent boils and abscesses.
- Adverse reaction during blood transfusion.
- Lower respiratory infection such as pneumonia.
Diagnosis Of Selective Immunoglobulin A Deficiency
Physicians often suspect selective immunoglobulin A deficiency (IgA) deficiency, when a patient has recurrent attacks of certain ailments such as gastrointestinal infections, cold and cough, ulcerative colitis, sinusitis, etc.
After a detailed history and examination, he may recommend the patient to do serum blood test to find the normal value of IgA antibodies. Absence or low level of IgA antibodies may reveal Immunoglobulin A deficiency.
The tests generally done are:
- Complete blood count
- Urine analysis
- Blood serum for IgA antibodies
- Thyroid function tests
- Lung function test
Treatment For Immunoglobulin A Deficiency
There is no treatment available to cure IgA deficiency permanently. Research is still in its primary stage to find the way for replacing IgA immunoglobulin. Hence the aim is to treat the chronic condition with which the patient is suffering. In many cases broad spectrum antibiotics are used to treat the infection.
For autoimmune diseases anti- inflammatory medications are used to alleviate pain and swelling. When endocrines are involved, hormone therapy may be indicated.
Certain home care tips may help such patients to prevent recurrent infection that is produced due to selective IgA deficiency.
- Patient should avoid mingling in crowds to prevent respiratory illnesses.
- Maintain hygiene to prevent gastrointestinal problems such as diarrhea and dysentery. Wash your hands with soap and water before eating food. Eat only properly cooked food and drink boiled water.
- Stay away from people suffering from cold and flu. Wear a mask if you are near a person who is suffering from upper respiratory tract infection.
- Do not smoke and avoid alcohol.