Fluctuating Levels of Serum IgA in Individuals with Selective IgA Deficiency

Abstract

Monitoring of donors with selective IgA deficiency, i.e., with less than 0.5 mg IgA/l, led to the observation that serum IgA levels wer not constant. Small but significant fluctuations in IgA levels were noted (coefficient of variance: 143%) which were greater than the variability inherent in the testing methodology (coefficient of variance: 10%). These fluctuations created difficulties in terms of defining IgA-deficient blood products and had implications with respect to the mechanisms involved in IgA deficiency. With respect to supplying IgA-deficient blood products, in our experience a cutoff level of 0.5 mg/l should be the maximum permissible IgA concentration in order to ensure that no adverse reactions occur in individuals with class-specific anti-IgA.

Food antibodies, intestinal permeability and HLA status in IgA deficient blood donors identified by a new rapid screening test

“…The fluctuation in IgA levels in these subjects within a 6-month period was an unexpected finding, with four of the original twelve showing normal values on repeat testing. Only one longitudinal study of IgA levels has been reported [22], and the authors found a degree of fluctuation in IgA level which was greater than the variability inherent in the methods used for testing. The findings in this study confirm this, and indicate that caution is required in labelling individuals as IgA-deficient.…”

Recombinant human immunoglobulin (Ig)A1 and IgA2 anti‐D used for detection of IgA deficiency and anti‐IgA

“…It has been shown that the serum levels of IgA in individuals with selective IgA deficiency are fluctuating. 21,22 On this background, Laschinger and coworkers 21 recommended that every single donation of fresh-frozen plasma to be used for IgA-deficient patients should be quantified for IgA. Koskinen and coworkers 22 ascribed the fluctuations to methodologic and biologic variations at levels close to the detection limit of the method.…”

Transfusion management of an IgA deficient patient with anti‐IgA and incidental correction of IgA deficiency after allogeneic bone marrow transplantation

“…IgA-deficient plasma or cryoprecipitate must be obtained from IgAdeficient donors. Although the IgA concentration in blood components that can be tolerated by patients with anti-IgA is unknown, it is recommended that IgAdeficient donors have serum IgA levels less than 0.05 mg/dL [18].…”