IgG anti-IgA antibodies in paediatric antibody-deficient patients receiving intravenous immunoglobulin
Torabi Sagvand B1
Immunoglobulin replacement therapy is an effective route of management for both infections and non-infectious complications in predominantly antibody deficiency (PAD). Trace levels of IgA (ranged from 0.4 to 2500 mg/ml), which exist in all immunoglobulin products, could lead to an increased susceptibility for adverse reactions in PAD patients. Furthermore, the exact mechanism which stimulates the anti-IgAantibody production in PAD is still unknown. The aim of this study was to evaluate IgGanti-IgAantibodies in PAD patientsreceivingintravenousimmunoglobulin (IVIg) and its predisposing factors.
Available patients with confirmed diagnosis of PAD, who underwent regular IVIg replacement therapy in our centre, were enrolled in the study. Control group included 24 healthy individuals as the negative control and eight symptomatic patients with IgA deficiency as the positive control groups. IgGanti-IgAantibodies level was measured by the ELISA method.
A significant difference was observed between Anti-IgA level of common variable immunodeficiency (CVID) and other PAD groups (p=0.02). Moreover, six CVID patients were seropositive for the IgGanti-IgA antibody, with higher susceptibility to the adverse reactions (p<0.001). IgGanti-IgA level has a negative relationship with serum IgA level (r=-0.06) and IVIg treatment duration (r=-0.006).
Our data suggested that there was a significant association between anti-IgA antibody presence and the adverse reactions, especially in CVID patients with higher susceptibility to produce this constitutional antibody.