October 28th, 2010
03:21 PM ET

How serious is selective IgA deficiency?

As a feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

From Indu, Waukesha, Wisconsin

"My 3-year-old daughter has been diagnosed with selective IgA deficiency. I am really worried. Can you please tell me what is this? What are her risk factors and will she live a normal life? Since three months she has had recurrent sinusitis infections and her blood test showed this deficiency ( IgA =6), No one in our family has this and both my husband and I are quite healthy. What are her options, treatment and any latest information/research in this field?"


Indu, Thank you for your question. I know, as a parent, that it can be scary when the doctor tells you that something isn’t quite normal with your child, and you want to understand what may be wrong.

The immune system protects us from harmful substances—called antigens—which include bacteria, viruses, toxins, fungus, cancer cells, and allergens. When the body senses the presence of an antigen, it fights it with antibodies, which attach to the foreign substance and help the immune system to destroy them. When the immune system doesn’t produce enough antibodies to fight the antigens it’s called an immunodeficiency disorder.

You indicated that your daughter has experienced recurrent sinus infections since she was 3 months old, which is probably why her physician tested her immunity levels —to find out why she might not be fighting off her recurring  infections. The immunoglobulin test is a tool that medical professionals can use to help diagnose when the immune system isn’t working properly. People can be born with immunodeficiencies or acquire them through illness or as a side effect of medications. When a child has frequent or unusual infections, doctors may suspect an immunodeficiency.

Our bodies produce five types of antibodies including IgA, which is found in mucous membranes, IgG which is found in all body fluids and fights bacterial and viral infections, IgM, found in blood and lymph fluid and is the first line of defense fighting new infections, IgE, which fights allergic reactions, and IgD which is found in the blood and whose function is still uncertain to immunologists. IgA, IgG and IgM are often measured together because they can give useful information about how the immune system is functioning toward infection or autoimmune diseases.

Selective deficiency of IgA is the most common immune disorder and is less harmful than other disorders, according to information from the National Institutes of Health. People with this condition have low or deficient levels of immunoglobulin A, the antibody that protects the body and is found in high concentrations in mucous membranes in the respiratory passages, gastrointestinal tract, as well as in tears and saliva.

Emory University pediatric allergist Dr. Karen DeMuth said “I would never diagnose a child that age with selective deficiency of IgA,” explaining that more information is needed about her case, and adding that children's immune systems are not fully developed at her age. DeMuth strongly advises that your daughter have a consultation with an immunologist, and she notes that the American Academy of Allergy, Asthma and Immunology is an excellent resource for finding a specialist, as well as for information.

While no specific treatment is available for selective deficiency of IgA, it’s important to treat any bacterial infections with antibiotics to prevent them from recurring. If a specialist agrees that your daughter has the disorder, it’s important to know that sometimes this condition will disappear without treatment, and your medical professional is likely to recommend retesting your daughter to see if the deficiency resolves over time.

soundoff (1,378 Responses)
  1. Brent

    My oldest son was diagnosed with this at age 1 1/2 after a series of illnesses including a skin rash (possibly fifths disease), the shinges and pneumonia over the course of a month. He tested with a similar number. A year later, he tested a bit higher, but still deficient and at 3 1/2 he tested at a normal level, I believe 32, at the time. He does fine with everything at this point. A couple of years later, I was diagnosed with a low IgA (not quite deficient, but below normal) and I can say that outside of being more susceptible to some things I have lived a normal life, playing sports throughout and continuing to swim today.

    October 28, 2010 at 22:53 | Report abuse | Reply
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    October 29, 2010 at 07:09 | Report abuse | Reply
  3. Josy

    what is oligospermaia. please i'd like to know what causes it and how it can be cured

    November 4, 2010 at 10:51 | Report abuse | Reply
  4. Lauren

    I was diagnosed with IgA deficiency at age 18 with an IgA <6. No family history of it. For years I had experienced recurrent severe sinus, eye, and respiratory infections that would take much longer than normal to clear. This was the reason I had finally been tested for various immune deficiencies. At 18 I required a tonsillectomy and even further surgery due to an infection that wouldn't allow the incisions to heal. At that point I was referred to an immunologist who I have seen every year since. Due to my frequent infections he recommended prolonged prophylactic antibiotic therapy to try and help prevent some of these infections. Since that time (7 years ago) I have been on erythromycin every day, September-May and go off of it during the summer months. This has cut down on my number of infections. (So it is not true that there is no treatment available). Some years are better than others, but overall it has helped me a lot. Besides that I live a completely normal life in every aspect, so I would try not to be too worried.

    I have done a lot of reading on this subject and know that the severity of symptoms of IgA deficiency varies greatly with each person. Some people have no symptoms at all and others get quite ill with various infections frequently. Since your daughter is so young I am sure they will keep a close eye on her and treat her infections as they arise. When she gets older, if her levels have not risen to the normal range and she's still experiencing recurrent infections, maybe an immunologist could discuss prophylactic treatment options. But hopefully it makes you feel better to know that I've been told my deficiency is on the more severe side and I live a totally normal life besides the infections. Hope that helps! Good luck!

    November 8, 2010 at 02:12 | Report abuse | Reply
  5. Know the Cause

    Many sinus/throat and other infections (including Allergies,arthritis,asthma,cancer,diabetes,digestive disorders,mental disorders,etc.) are caused by fungi. I have come to think disease is caused by Fungus until proven otherwise. Removing Fungal food (ant-biotics, sugar, corn, peanuts, anything that is or is made from grain) will do a lot to starve the pathogen known as Fungus. The introduction of Pro-biotics (for life) are essential for regaining and maintaining health. 70-80% of our immune system lies in our digestive tract. Fungus has the ability to make us sick, change our immunity (suppress), change our hormones and infiltrate our cells and break the DNA and replace it's own Fungal DNA,causing a Fungal/Human mutated cell (cancer). Go to http://www.knowthecause.com for more info (this web site saved my life). May God Bless you and your children.

    January 24, 2011 at 23:17 | Report abuse | Reply
  6. Eileen

    Our 43 yr. old son has been diagnosed w/iga. The gastroent has scheduled a colonoscopy & endoscopy. He is taking Dilantin due to a mixed glioma brain tumor. He has had 2 brain tumor surgeries ('98 & '05) & is now scheduled for radiation due to regrowth of tumor. How does all of this interact? Which doctor should he consult first gastorent, radiology onc., or neurologist? We appreciate your advice.

    January 26, 2011 at 21:29 | Report abuse | Reply
  7. allan frohlinger

    may I ask if there are any forums or dissucscins on iga, particulary in Ontario or elesewhere or any

    August 3, 2011 at 01:34 | Report abuse | Reply
  8. evera

    Immunodeficiency disorder is not a problem for child. Because in today world doctor are so active to overcome from this problem. Now we are saying about new problem for the cold country. the problem is sinus infection. so we have to take care our health for better tomorrow.

    November 14, 2011 at 14:04 | Report abuse | Reply
  9. Mary

    Should someone who has IGA deficiency get the shingles vaccine? I had chicken pox as a child and now am a senior citizen.

    February 20, 2012 at 11:42 | Report abuse | Reply
  10. barbara o'connor

    hello doctor,
    i was tested for celiac a few months ago and the results were negative. my doctor said that i did have an iga deficiency. reading the symptoms of iga deficiency i learned that i have at least a 10% increased chance of having celiac disease. are there other blood tests to check for celiac? the reason i had een tested was that i have premature osteoporosis, low vitamin d, at least 3 dozen kidney stones since age 25–i am 55 now, skin rashes since infancy, chronic constipation and a nasty rash on my neck, arms, shoulders that erupts into sores several days after a deep itching under the skin. i do have symptoms of iga deficiency, pneumonia, bronchitis, many colds, asthma. what i am concerned about is my father passed away from pulmonary fibrosis which i have learned could be caused by undiagnosed celiac disease. do you think all this is related to iga deficiency? if so, how could i be tested without going through an intestinal biopsy. thank you so much for taking my question. barbara

    March 6, 2012 at 16:26 | Report abuse | Reply
    • PAM

      People with IgA deficiency will oftentimes have false negative tests for celiac disease. Your doctor should have been aware of that. Good luck. I have IgA deficiencey and have been having a hard time this winter gettnig over pneumonia.

      February 4, 2013 at 09:49 | Report abuse |
  11. Jenna

    My 21/2 year old little boy we just found out he has IgA im so scared he stays sick any advice would be so helpful please from a very scared mommy any other moms that have had this problem please help me

    July 5, 2012 at 20:35 | Report abuse | Reply
    • Nicole

      My daughter is now 9. She was very healthy until right before her 6th birthday. She very rapidly got sick and was hospitalized with double lung pneumonia. She has since been diagnosed with the low IGA or selective IGA deficiency and conic asthma. And her illness with that is very rapid reoccurring pneumonia. The only advise I would give to you is have her checked for asthma and just stay on top of the infections because these kids do get rapidly sick and in my daughters case go downhill fast. However when caught early has kept us out of several hospital stays. Good luck and best wishes

      February 21, 2015 at 00:43 | Report abuse |
  12. wendy

    Is there any connection between ulcers/ h pylori and IGA deficiency. My daughter was recently hospitalized for abd pain and Gall Bladder isn't emptying all the way was the results with the Hida Scan. She was also diagnosed with Candida Esophagitis with the EGD that was preformed.All other tests were negative. My daughter was diagnosed when she was about 3 with IGA deficiency. The levels came up and then went down. What is the connection between IGA deficiency and the gut? I am a RN.I am looking for answers.

    September 2, 2012 at 08:47 | Report abuse | Reply
    • kayjhar

      Hello Wendy. I saw your post abt your daughter who was diagnosed with candida esophagitis. I am wondering if you ever found out the cause. My son has just been diagnosed with that and they are now trying to determine the root cause. Any help would be greatly appreciated. Thanks you.

      June 12, 2014 at 11:44 | Report abuse |
  13. Mandie

    I have aIway's been a healthy woman, but broke out in hives the day after my 35th birthday. I went to my regular Dr and was put on prednizone. It has now been 4 months and I have been to five different doctors including two allergy specialists. After having severe hives the whole time (save maybe 14 days) unless taking prednizone, blood tests confirmed I have an IGA defiency. I have spent months researching but cannot find anything on severe cases of IGA with chronic utecaria. The specialist said due to the severety of my symptoms it's considered an autoimmune disease. I cant find anything about people with severe symptoms like mine . I have been on prednizone most of the four months and break out in hives from head to toe if im not on prednizone. I have had severe facial swelling, difficulty breathing and ( itchy & painful burning) hives. I have also had three epipen shots due to burning hives covering over 75% of my body. I have looked into herbal remedies but not sure what to use. I take one a day women's multivitamins (which include 1000 mg Vitamin D) and 1000 mg extra Vitamin C, 1000 mg of L-lycene and try to eat healthy. I currently take 3 prednizone a day just to keep the hives from returning. I feel like my quality of life is deminishing and just want to feel alive again. Im sure my husband and kids feel the same way. If anyone has suggestions, ideas or similar symptoms please let me know.

    November 4, 2012 at 01:59 | Report abuse | Reply
    • Karen

      Hi Mandie
      I have had the exact same symptoms and treatment for 8 months now. After trying everything under the sun I finally received a diagnosis yesterday – Imunoglobulin Deficiency.
      If you have since found a better solution than cortisone please would you let me know. I have also done a fair amount of research and cannot find much.
      I also received the news that I am peri menopausal which is adding to the itching. I am hoping that HRT's will have a positive effect since there is no cure for IgG. – Possibly I'll try the homeopathic approach first.

      January 16, 2014 at 00:05 | Report abuse |
    • Zoey

      I know this post is a few years old, but I am having the same issues. I am 38 years old and have had horrible hives with facial swelling daily, for over 6 months. I have been diagnosed with an IGA deficiency. Prednisone is the only thing that has given me any relief, but I still have hives while I'm on it. I am miserable. I have had numerous appointments, biopsies, and have had over 50 viles of blood taken since this has started. I would really love to get in touch with someone who has been or is going through this. Thanks.

      April 22, 2016 at 22:38 | Report abuse |
    • Bobbie

      Mandie I have Alpha-Gal caused by a tick bite and what you discribe sounds just like it. Look it up and see an allergist to be tested. It is a delayed reaction to mammal meat.

      November 9, 2016 at 12:08 | Report abuse |
  14. Mark

    For me, it’s been pretty bad: a losing lifetime battle against continuing sinus infections. I just turned 57 yesterday and I’m pretty surprised I made it this long. I somehow managed to work (sporadically) until I was 52 and save some money. I’ve since been living like a pauper to make my small nest egg last as long as possible, but I’ll be running out next summer and I can finally put a stop to my suffering. That’s the cruel irony of it all: the curse of a severely weakened immune system and a strong survival instinct. But at least I’ll be forced to end it when the last of my money runs out.

    The one major mistake I made in life was not moving to a desert climate where I felt so much better the few times I was out there visiting. I know if I was in Arizona right now I wouldn’t feel like “drilling a hole in my face” to relieve the throbbing pressure. But I never really felt physically up to the challenge of relocating and trying to find another job with flexible hours to accommodate my health problems. So I stayed trapped in my misery in Michigan, with little chance of ever having a reasonable quality of life. I just feel bad for my daughter. She’s an only child and I know she will take it hard, but I’m hoping she will understand and will somehow be able to overcome it in the long run.

    December 12, 2012 at 12:57 | Report abuse | Reply
    • Alison

      Mark, I just saw your response as I'm researching this issue for my 3 1/2 year old son. It breaks my heart to hear how much you have suffered. I pray you will find some relief soon. It sounds like you are considering drastic measures. Please talk to your daughter about how much pain you are in to get help with your situation. It would crush me if my parents felt this way & never talked to me about it. I do not think she will over-come it & I pray you will not go down this path. Is there an allergist you could work with to help with the symptoms? I feel like we have found an allergist that is trying to help us get to the root of my son's problem versus just prescribing more medications. Many prayers sent your way.

      January 22, 2013 at 14:29 | Report abuse |
    • Mary

      Mark, my heart breaks for you! I hope that you have begun the process of trying to get Social Security Disability... It is a long process, but you may be eligible to get it, or even some other kind of help through your local Social Services. I wanted to share with you something that has helped me immensely. In 1997, I was very sick (I too have IgA deficiency) and a co-worker told me that milk had an enzyme in it that caused mucous production. At the time, I was a vegetarian, but still ate dairy products, minimally. After some time of her trying to convince me & my dr. not being able to help with the use of antibiotics, I finally gave in & stopped using dairy. It was a while before I found soy milk to replace milk & then I moved to rice milk & today, I use almond milk. My re-current sinus infection rate significantly decreased just by not using milk/cheese, etc.. It may be a long shot, but, who knows, maybe it will help! We will be praying for you!!

      April 22, 2013 at 11:10 | Report abuse |
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    July 3, 2013 at 11:18 | Report abuse | Reply
  16. Shelley

    I am 61 years old. A few years ago, I was diagnosed with IgA deficiency and IgG subclass deficiency. I may have had this problem when I was a child, as I had strep throat many times per year. Before my diagnosis, I had EIGHT sinus infections in a year. When I took antibiotics they didn't begin to work for many days, since they work with the immune system and my immune system isn't good. Having IgG subclass deficiency makes the problem more serious than having only IgA deficiency. Western medicine offered me little hope.

    Finally, I began seeing a naturopathic physician. I feel that she saved my life. I haven't had a sinus respiratory infection since 2005. Naturopathic physicians are doctors who specialize in natural medicine. This approach isn't easy, as I take about 50 pills and capsules a day. But I am leading a normal life now. I hope this information helps other people. You can find help outside western medicine. The natural remedies don't cause yeast infections, they prevent yeast infections!

    July 6, 2013 at 15:30 | Report abuse | Reply
  17. Barbara

    My daughter was diagnosed 35 years ago with IGA deficiency. Se was constantly sick, but grew up and she is just aware that when she gets a cold she might need to have antibiotics to get over it. I was/am the same way, so was my mother. No one ever told us it was genetic, until recently. And, that is when due to effects of chemotherapy, my blood counts dropped and I was hospitalized. Here is the important part: IGA ANTIBODIES reacted to the blood products, sent me I to anaphylactic shock which is not recommended for a 66 year old cancer patient. I am lucky to be alive. No one ever told me about this possibility with her or the genetic link. After surviving the episode, the (code team) asked me if any one ever told me I was IGA deficient. So, now I know. Now she knows. No blood transfusions unless the blood is "washed" , or you may not survive the transfusion.

    July 13, 2013 at 20:16 | Report abuse | Reply
  18. Alicia

    I was born with IGA deficiency and I have been sick my entire life everything from asthma to allergies to infections and flus and stomach problems and removal of my gall bladder and appendix and when I was 21 I found out I have celiac diease and now possibly lupus and im 27 years old

    January 20, 2014 at 02:53 | Report abuse | Reply
  19. Amy

    The postings look old on this thread however I couldn't help but share. I began with uticaria (hives) that were so intense they would wake me from a sound sleep since puberty. In addition I would have migraine headaches every 6-10 days that would bring me to my knees vomiting for two days. My chest would turn bright red (blotchy) people always asked me why. I was prescribed imitrex that helped the migraines if I caught them in time, but nothing else touched the tiny raised hives that I could sit in a tub of ice with a brush and scratch until I cried. At 35 I went to a gastro Dr and he scoped through esophagus and tested for celiac disease. The following week he saw me back in his office to tell me that both tests came back neg. for celiacs. He gave me topical cream, as a method of coping and not an intended cure for the hives. He asked that although my test came back neg for celiacs, he wanted me to stop eating gluten. He said he would do some further research and see me in a month. I was discouraged leaving his office but began that day eliminating gluten from my diet. Within a week I began feeling better. By the time the month was up and I was back in his office I was on Cloud nine. My hives (that were typically on my lower legs and forarms) had gone away and the areas that I had scratched so severely through the years was looking 50% improved. I had only had one migraine on day one or two of being off gluten and my life was changed.

    July 9, 2014 at 23:56 | Report abuse | Reply
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  22. Carolyn

    I have been sick all of my life. Sinus infections, walking pneumonia, pleurisy ,GERD, fungal infections and yeast infections, among quite a few other illnesses. I am 63 years old and after having Nissan fundolopitation(?) for GERD, I was severely ill. I had tissue completely dissolve off of 2 teeth which resulted in 2 tissue grafts, a dry, barking cough and my asthma acting up severely. Finally, I was diagnosed with Selective IgA deficiency and am now on a prophylactic antibiotic (z pack) 500 mg 2 x a week. I am constantly getting fungal infections and am on Nystation when they occur. Now I am starting to get yeast infections again, but around the inside of my inner thigh and that area. I' have a very good immunologist but I'm becoming exhausted from being sick ALWAYS. Dr. Gupta doe you have any advise> I am getting overwhelmed.

    January 18, 2015 at 11:31 | Report abuse | Reply
  23. Kristin

    My son has been battling severe respiratory/sinus infections, asthma and allergies since he was very young. He has had violent stomach viruses in the past. He will be ten and as I write this is battling the flu even though he had the shot. He will be ten years old soon. My question is in the last two years he has battled severe constipation requiring 3 inpatient bowel clean-outs and now dependent on multiple laxatives per doctor orders. They can't offer me an answer. He was ruled out for Hirschsprungs and had biopsies and blood tests which came back negative for celiac. He has been IgA deficient since a baby. Can IgA Deficiency cause severe ideopathic constipation, even when you're doing the high fluid/fiber intake daily? I am desperate for answers. He was also severely anemic at two years of age and had an extremely elevated platelet count. He was admitted and given two transfusions of packed red cells. Shortly after he was diagnosed with IgA. The doctor told me it was no big deal. It has been a very big deal and has severely limited his life. Having the adenoids out did not help. He is supposed to take three caps Miralax per day and four Dulcolax per week. Somebody please help me if you know anything about IgA and constipation – thank you so much!

    January 21, 2015 at 22:12 | Report abuse | Reply
    • Laquanda

      I just ran across this site. I've been battling iga since 2004 but I had problems since was born. No doctor could figure me out. I use to break out in hives very bad, had stomach problems and upper respiratory problems. I've had several surgeries.Iga causes female problems as well. I also suffer with body pain. I was also diagnosed with graves in 2015. Your thyroid operates your entire body. Breaking out with no explanation and having false readings from test all boils down to thyroid issues. Ever case is different but it toke my organs shutting down and me almost dieing in intensive care for them to finally figure it was graves disease. I hope this was helpful. I wish everyone the best.

      January 21, 2018 at 17:12 | Report abuse |
  24. elrika

    I also want to know if there is a link between iga dificiency, specific antibody difiecency and constant faceal impactation. My daughter 6 has all 3 and we csnt seen to stop tge impactstions! We've been for numerous bloodtests, biopsies, enimas, lots of docters, dieticians..... please help.

    June 30, 2015 at 16:14 | Report abuse | Reply
  25. sandy

    I have been diagnosised with IGA defieciency, I have battled severe constipation for many years. This year I was also diagnosised with a severe case of Hashimatos when doctors missed it for years because general panel on the thyroid always showed up with in range until a doctor checked for the TPOs (antibodies). They put me on low dose synthroid and the only thing I can say is that I have not suffered one day from constipation since the synthroid!

    January 28, 2016 at 22:02 | Report abuse | Reply
  26. sheriann1

    I'm 50 years old, and have had a lifetime of odd health concerns....nearly every time I have surgery, I Have issues; I always get sinus and urinary tract infections which take forever to get over. I've had C. Diff 12 times and in 2004, I had an aneurysm and stroke due to an infection that traveled to my brain.
    My GI doc ran some blood tests on me which showed my IgA levels were low. It explains so much..my dry eyes, my chronic infections and even my eventual stroke. I'm anxiously waiting to see an Immunologist to see about treatment.

    March 29, 2016 at 23:10 | Report abuse | Reply
  27. jayesh

    sir i have a doubt dat, i am still suffering with ma throat infection.after that i get developed ear problems also. is it the result of my throat infection?? Why this recurrent infection is occurring??? could you please find me a solution.

    July 2, 2016 at 16:19 | Report abuse | Reply
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  29. Name*karen Hodgkinson

    Is there anything I can take to help me with IGA deficiency I have had a cough now on and off since January had CT scan and nothing shows only my immune system. I just need something to help my cough as it's making me sick sometimes.

    Hope u can advice me

    March 16, 2017 at 04:40 | Report abuse | Reply
  30. Edge-of-the-Forest Farm Momma

    My 8-year-old son was diagnosed with Ig-A deficiency in January 2017. He also has vitiligo, itchy skin rashes on his elbows (He's been tested for celiac, but it came back negative, though Ig-A deficiency can mask celiac), and has significant food and environmental allergies. We are headed to Children's Hospital to see an immunologist at the end of this month (April, 2017). In the meantime, we are having a mold problem in our house because of a pipe that broke in December 2016, and the water mitigation company didn't get everything dried out. I am wondering (suspecting, really) if the mold is negatively impacting my immune-compromised child. Any suggestions? He's constantly battling a sinus infection!

    April 13, 2017 at 15:33 | Report abuse | Reply
  31. Name* Jessica Hill

    Hi there am Jessica and my daughter was dinosssd with asthma at 6 months old. Docotors didn't care we where coming back over and over again. Finally I got a specialist and now thst she's 8 have finally found out she was born with a IGA blood deficiency. 8 years it took them help my child. And still there doing nothing. She continues to get infections and all they do is push meds. I am writing to see if I can find some answers. My daughter hasn't been able to have a normal childhood because she's always sick. Am looking for any answers and help I can get for my daughter and our family.
    Thank you for your time

    July 22, 2017 at 07:49 | Report abuse | Reply
  32. Sandra

    Hello, My 10 year old daughter shows protein and blood in her urine and according to a nephrology doc from Children's hospital, they believe she has IgA. Is there any way to avoid the blood pressure meds as what the docs are recommending for treatment at this time. Can we not take the meds and see if by change the protein levels will decrease or it's not safe to wait without treatment?
    Thank You!

    December 4, 2017 at 16:05 | Report abuse | Reply
  33. Natalie

    My daughter has low Iga levels in her blood deficiency. We have since discovered 2 lumps. 1 in her neck, back bone n 1 under her lymph nodes, cheek bone. She has an ultrasound. I am very worried. Please can you help me? Are these both connected?

    December 31, 2018 at 22:45 | Report abuse | Reply
  34. Rebekah

    I was diagnosed with an IgA deficiency at around age 4. I was having 12 or more sinus and ear infections a year and the doctors were concerned about cystic fibrosis. That is when they discovered that I do not have any IgA’s. As a child I was more prone to infections like sinus infections, ear infections and skin infections. However, as I grew older I became sick far less often. I’m 21 now and I’m still cautious because I know that I am more prone to sickness and infection, but it really does not bother me and I’ve lived a totally normal life. Hope this makes you feel at ease!

    November 15, 2020 at 23:29 | Report abuse | Reply
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