SELEKTIVNA IgA DEFICIJENCIJA KOD DECE
DOI:
https://doi.org/10.46793/PP260122006PKljučne reči:
primarna imunodeficijencija, infekcije, IgA deficitApstrakt
Selektivna IgA deficijencija predstavlja najčešća primarna imunodeficijencija, a definiše se kao nivo serumskog IgA niži od od 0,07 g/L uz nedostatak sekretornog IgA, kod devojčica ili dečaka uzrasta ispod 4 godine. Ova deca imaju normalne nivoe IgG i IgM uz adekvatan odgovor antitela na primenu vakcina. Nedostatak IgA kod dece povećava podložnost respiratornim i gastrointestinalnim infekcijama, koje mogu biti prolongiranog trajanja ili imati rekurentni karakter. Mnoge studije ukazuju na jasnu povezanost alergijskih bolesti i deficita IgA. Česte autoimunske bolesti udružene sa selektivnom IgA deficijencijom su: idiopatska trombocitopenijska purpura, autoimunska hemolitička anemija, dijabetes melitus tipa 1, vitiligo, Gravesova bolest, tiroiditis, reumatoidni artritis, sistemski eritemski lupus i celijačna bolest. Pojava maligniteta kod ovih bolesnika je sporadična, a najčešće su adenokarcinom želuca i B-ćelijski limfomi. Takođe, selektivna IgA deficijencija može biti udružena sa drugim primarnim imunodeficijencijama, kao što su deficit potklasa IgG2 i IgG3. Ne postoje jasne preporuke za specifično lečenje bolesnika selektivnom IgA deficijencijom. Ovi bolesnici zahtevaju kliničko praćenje zbog prolongiranih i/ili rekurentnih infekcija, laboratorijsko praćenje, lečenje pridruženih alergijskih i autoimunskih manifestacija, potrebu za primenom polivalentne pneumokokne vakcine i supstituciju intravenskih ili subkutanih imunoglobulina.
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