immunology allergic disorders
Selective IgA Deficiency
Treatment of Selective IgA Deficiency
Antibiotics as needed for treatment and, in severe cases, for prophylaxis Avoidance of blood products that contain IgA Allergic manifestations are treated. Antibiotics are given as needed for bacterial infections of the ears, sinuses, lungs, or gastrointestinal or genitourinary tracts. In severe cases, antibiotics are given prophylactically. Because immune globulin replacement therapy contains mostly IgG and minimal amounts of IgA, patients with IgA deficiency do not benefit from it. However, there still is some risk of sensitizing patients to IgA or triggering an anaphylactic reaction in those who previously developed anti-IgA antibodies. Rarely, if patients have no antibody response to vaccines and if prophylactic antibiotics are ineffective in preventing infection, specially formulated immune globulin preparations that contain extremely low levels of IgA can be tried and may be somewhat effective. Blood products that contain IgA are avoided in patients with IgA deficiency because IgA can elicit an anti-IgA–mediated anaphylactic reaction. If transfusion of red blood cells (RBCs) is needed, only washed packed RBCs can be used. If other blood components are needed, they should be IgA-deficient, and cellular components should be washed. Patients with selective IgA deficiency are advised to wear an identification bracelet to prevent inadvertent plasma or immune globulin administration, which could lead to anaphylaxis. 