Immunoglobulin A deficiency in children, an undervalued clinical issue

Immunoglobulin A (IgA) is the principal antibody in secretions that bathe the gastrointestinal and respiratory mucosal surfaces and acts as an important first line of defense against invasion of pathogenic micro-organisms. The reported prevalence rate of complete IgA deficiency in healthy children r...

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Bibliographic Details
Published in:Clinical immunology (Orlando, Fla.) Fla.), 2019-12, Vol.209, p.108293-108293, Article 108293
Main Authors: Koenen, M.H., van Montfrans, J.M., Sanders, E.A.M., Bogaert, D., Verhagen, L.M.
Format: Article
Language:English
Subjects:
Animals
Autoimmune Diseases - immunology
Child
Children
Clinical presentation
Diagnostic approach
early childhood
Humans
IgA deficiency
IgA Deficiency - immunology
Immunoglobulin A - immunology
Long-term consequences
Microbiota
Prevalence
Respiratory Tract Infections - immunology
Review
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Summary:Immunoglobulin A (IgA) is the principal antibody in secretions that bathe the gastrointestinal and respiratory mucosal surfaces and acts as an important first line of defense against invasion of pathogenic micro-organisms. The reported prevalence rate of complete IgA deficiency in healthy children ranges from 1:170 to 1:400, and as a solitary condition, it is often considered of limited clinical importance. However, patients with IgA deficiency can develop recurrent respiratory and gastrointestinal infections, as well as allergic and autoimmune diseases. In children referred for recurrent respiratory tract infections, the observed prevalence rate increases more than tenfold. This review discusses several aspects of IgA deficiency in children, including immunologic and microbiome changes in early childhood and the potential consequences of this condition in later life. It illustrates the importance of early identification of children with impaired IgA production who deserve appropriate clinical care and follow-up. •IgA deficiency occurs in 1:170–1:400 children and can be transient and/or partial.•IgA deficiency predisposes children to infections, allergy and autoimmune disease.•In children with recurrent respiratory infections IgA deficiency occurs over tenfold.•Lung damage and hearing loss can occur as a sequelae of symptomatic IgA deficiency.•Lack of IgA in children
ISSN:1521-6616
1521-7035
DOI:10.1016/j.clim.2019.108293