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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?"

Answer

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.


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