Patients with selective immunoglobulin a deficiencyretrospective evaluation

In the study, all patients who applied to the Pediatric Health and Diseases Clinic of the Akdeniz University Faculty of Medicine for any reason between January 1, 2017, and December 31, 2021, and whose immunoglobulin levels were examined were included in the study. Cases with IgA < 7 mg/dl were evaluated among these patients. Among cases with low IgA levels, the clinical and laboratory data of those diagnosed with selective IgA deficiency according to ESID criteria were assessed. They were examined for associated additional diseases. This study aimed to identify the possible comorbidities that may develop during the follow-up of patients with IgA deficiency. A total of 8634 cases were screened. Low serum IgA levels were found in 432 cases. Out of these 432 cases, 40 received a diagnosis of selective IgA deficiency. Due to the retrospective nature of the cases and the unavailability of subsequent IgA values, the course of IgA levels could not be examined. Patients diagnosed with selective IgA deficiency were evaluated based on gender, family history, additional diseases, frequency of infections, consanguinity in parents, hemogram values, other immunoglobulin levels, lymphocyte subsets, symptomatic nature, age of symptom onset if symptomatic, age at diagnosis, and other autoimmune tests performed. Patients with additional diseases that could affect IgA levels, such as bone marrow transplant, solid organ transplant, were excluded from the study. The average age of symptom onset was found to be 9.6 in females and 9.5 in males. The average age at diagnosis was 10.3 in females and 10 in males. These data indicate that patients were diagnosed within the first year after the onset of symptoms. When screened for presenting symptoms, 12.5% of patients sought medical care due to growth and development retardation complaints. 32.5% presented with allergy symptoms, notably allergic rhinitis. 25% had autoimmune diseases and symptoms. 7.5% sought medical care due to frequent infections. 5% were observed with malignancies. This 5.1% rate is significantly higher compared to other studies. 17.5% sought medical care with complaints outside of these symptoms and diseases in the other categories. Previous studies have shown that selective IgA deficiency can transform into many other immunodeficiency diseases, particularly common variable immunodeficiency (CVID). However, in our study, due to the lack of repeated immunoglobulin screenings, a similar analysis could not be conducted. Based on all the data and previous studies, it is evident that identifying comorbidities in patients with selective IgA deficiency or paying attention during their follow-up could guide clinicians in taking preventive measures.