A case of selective immunoglobulin A deficiency associated with autoimmune gastritis

Selective immunoglobulin A (IgA) deficiency is considered to be the most common primary immune deficiency. Up to now, no specific genetic mutation causing this disorder has been found. True prevalence of selective IgA deficiency in the population is unknown, because in most cases it is asymptomatic and occurs as an incidental laboratory finding. In some patients, it can manifest by respiratory and gastrointestinal infections, as well as allergic and autoimmune disorders. According to the literature, autoimmune disorders in patients with selective IgA deficiency have a more aggressive course and a worse prognosis. This clinical case of a combination of selective IgA deficiency and autoimmune gastritis demonstrates that patients with primary immunodeficiency, especially adults, may not know about their disease for a long time. The paper may be of interest for practicing doctors of various specialties, first of all, for gastroenterologists, internists, general practitioners, and is intended to increase awareness about diagnosis of selective IgA deficiency. There is no specific treatment for this immunodeficiency, but one should bear in mind that blood transfusions and intravenous immunoglobulin preparations with high IgA content are contra-indicated in these patients due to a high risk of anaphylactic reactions.