Selective IgA deficiency is the most common humoral immunodeficiency. It's defined as serum IgA levels lower than 7mg/dl in individuals above four years old, and with normal values of IgM and IgG. There are also significant association between IgA isolated deficiency and autoimmune diseases. Few cases have been reported in the literature of the coexistence of sarcoidosis and IgA deficiency. The aim of this study was to report a case of this association.
Methods:
A descriptive case study of a patient monitored in the outpatient clinic of Immunodeficiencies at a university hospital and a brief review of the literature.
Results:
LMM, female, 52 years old, was admitted to the outpatient clinic of Immunodeficiencies on February 20th/2013 with a previous diagnosis of selective IgA deficiency. It was done on June/2010 when the investigation of uveitis without other signs and symptoms showed a blood IgA level < 7mg/dl changes in chest tomography compatible with sarcoidosis. She had 3 or more sinusitis per year and also recurrent urinary tract infections. She underwent surgery for cataract secondary to uveitis without complications and at the moment she is well and with no complaints. Selective IgA deficiency can be asymtomatic or can show a wide spectrum of clinical manifestations. The main clinical complaints that suggest its diagnosis are recurrent infections, severe allergic reactions and association of diseases with possible autoimmune mechanism, such as rheumatoid arthritis, systemic lupus erythematosus, thyroiditis and kidney diseases, which occur more frequently. Therefore it is recommended a clinical and laboratory work-up for the development of autoantibodies.
Conclusions:
In this case report, selective IgA deficiency was diagnosed during the investigation of an autoimmune disease not frequently associated with it, reinforcing the need of a wide immunologic work-up in every autoimmune condition.