Selective IgA Deficiency in Autoimmune Diseases

Abstract

SUMMARY utoimmune diseases occur when there is interruption of the usual control process, thereby allowing the immune system to malfunction and attack healthy cells and tissues. It usually involves both T-cell and B-cell responses. It only requires that the adaptive immune response be directed to a self-antigen and this is triggered by many factors e.g; genetic, environmental including infectious and noninfectious factors and loss of self-tolerance (Davidson and Diamond, 2001). According to the clinical manifestation, autoimmune diseases may be classified as systemic (e.g. systemic lupus erythematosus, or SLE) or as organ-specific (e.g. Graves’ disease). However, this clinically useful classification does not correspond to the underlying pathogenetic mechanisms. A multifactorial genesis, including immunological, genetic, endocrine, and environmental factors, is suggested by evidence from both human and animal studies (Shoenfeld and Isenberg, 1990). Selective IgA deficiency (sIgAD) is defined as the selective deficiency of serum immunoglobulin A (IgA) (ie, serum levels of immunoglobulin G [IgG] and immunoglobulin M [IgM] are normal) in a patient older than four years of age in whom other causes of hypogammaglobulinemia have been excluded (Yel, 2010). A Summary  138 The aim of this study was to investigate the prevelance of Selective immunoglobulin A deficiency in patients with autoimmune diseases and highlighting its possible pathophysiological mechanisms. This study was a case control study conducted on one hundred patients diagnosed to have an autoimmune disease ranging from 20 to 60 years of age attending the Ain Shams University clinic and twenty healthy individuals age and sex matched as control group. All participants were subjected to full history and clinical examination of the autoimmune disease, serum immunoglobulin A by (ELISA), routine laboratory & radiological investigations to exclude organ failure that may affect the study. Data was collected regarding gender, age, clinical history and specific investigations. Patients who were on current medications that may affect the results of the study, with organ failure, severely ill, pregnant females or patients with concomitant diseases that may affect the results of the study were excluded. In our study we found statistically highly significant evidence of selective IgA deficiency among cases having different autoimmune diseases included in our study regarding age, sex, type of autoimmune disease and duration of illness. 67% of the patients were found to have IgA deficiency and all of the control had normal IgA levels. The frequency of different autoimmune diseases involved in