Ludvigsson Jonas F, Neovius Martin, Hammarström Lennart
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,
J Clin Immunol. 2014 May;34(4):444-51. doi: 10.1007/s10875-014-0009-4. Epub 2014 Mar 2.
To examine autoimmune disorders in patients with IgA deficiency compared with the general population.
Nationwide prospective population-based cohort study. Through six university hospitals in Sweden we identified 2100 individuals with IgA deficiency (IgA levels < .07 g/L) diagnosed between 1980 and 2011. Each patient with IgA deficiency was matched on age, sex, place of residence, and year of diagnosis with up to 10 general population controls (n = 18,653). Data on nine autoimmune disorders were retrieved from the Swedish National Patient Register (including inpatient and non-primary outpatient care). Autoimmune disorders were defined as having at least two visits listing the relevant international classification of disease (ICD) code as main diagnosis. Prevalences and prevalence ratios (PRs) were calculated.
Individuals with IgA deficiency more often had celiac disease (6.7 % vs. 0.19 % in controls) and type 1 diabetes (5.9 % vs. 0.57 %) corresponding to a 35-fold higher PR for celiac disease and 10-fold higher for type 1 diabetes. Also for the other autoimmune diseases did we see statistically significantly elevated prevalences and PRs (juvenile idiopathic arthritis (0.76 % vs. 0.09 % in controls, PR = 8.9), systemic lupus erythematosus (0.57 % vs. 0.06 %; PR = 8.9), inflammatory bowel disease (3.9 % vs. 0.81 %; PR = 5.0; specifically Crohn's disease (2.4 % vs. 0.42 %; PR = 5.7) and ulcerative colitis (1.7 % vs. 0.46 %; PR = 3.9)), hypothyreosis (0.76 % vs. 0.16 %; PR = 4.6), rheumatoid arthritis (2.2 % vs. 0.50 %; PR = 4.5), and hyperthyreosis (1.7 % vs. 0.43 %; PR = 3.9), but not with myasthenia gravis (0.05 % vs. 0.02 %; PR = 3.0).
Individuals with IgA deficiency have a higher prevalence of several other autoimmune disorders.
对比IgA缺乏患者与普通人群自身免疫性疾病的情况。
全国性基于人群的前瞻性队列研究。通过瑞典的六所大学医院，我们确定了1980年至2011年间诊断出的2100例IgA缺乏患者（IgA水平<0.07g/L）。每例IgA缺乏患者在年龄、性别、居住地点和诊断年份方面与多达10名普通人群对照进行匹配（n = 18653）。从瑞典国家患者登记处（包括住院和非初级门诊护理）获取了九种自身免疫性疾病的数据。自身免疫性疾病定义为至少有两次就诊记录将相关国际疾病分类（ICD）代码列为主要诊断。计算患病率和患病率比（PRs）。
IgA缺乏患者更常患乳糜泻（6.7% vs. 对照组的0.19%）和1型糖尿病（5.9% vs. 0.57%），乳糜泻的PR高出35倍，1型糖尿病高出10倍。对于其他自身免疫性疾病，我们也观察到患病率和PRs在统计学上显著升高（幼年特发性关节炎（0.76% vs. 对照组的0.09%，PR = 8.9）、系统性红斑狼疮（0.57% vs. 0.06%；PR = 8.9）、炎症性肠病（3.9% vs. 0.81%；PR = 5.0；具体为克罗恩病（2.4% vs. 0.42%；PR = 5.7）和溃疡性结肠炎（1.7% vs. 0.46%；PR = 3.9））、甲状腺功能减退（0.76% vs. 0.16%；PR = 4.6）、类风湿关节炎（2.2% vs. 0.50%；PR = 4.5）和甲状腺功能亢进（1.7% vs. 0.43%；PR = 3.9），但重症肌无力并非如此（0.05% vs. 0.02%；PR = 3.0）。
IgA缺乏患者患其他几种自身免疫性疾病的患病率更高。
