Magen E, Waitman D-A, Goldstein N, Schlesinger M, Dickstein Y, Kahan N R
Leumit Health Services, Ashdod, Israel.
Clinical Immunology and Allergy Unit, Barzilai University Medical Center, Ben Gurion University of the Negev, Ashkelon, Israel.
Clin Exp Immunol. 2016 Jun;184(3):332-7. doi: 10.1111/cei.12765. Epub 2016 Mar 31.
Selective immunoglobulin A (IgA) deficiency (IgAD) is the most common primary immunodeficiency in the western world. The aim of the study was to investigate the prevalence and clinical characteristics of Helicobacter pylori-infected dyspeptic patients with IgAD. Case samples were drawn from all subjects ≥ 12 years of age (n = 104729) who had undergone serum total IgA measurements during 2004-14 for any reason at Leumit Healthcare Services (Israel) and had serum total IgA < 0·07 g/l. The control group was comprised of a random sample of remaining patients with a case-control ratio of 10 controls for each case. The dyspeptic diseases were identified and retrieved from Leumit Health Care Services electronic database using specific ICD-9-CM diagnostic codes. The case group included 347 subjects and the control group 3470 subjects. There were no significant differences in the prevalence of patients with dyspepsia [84 (24·2%) versus 821 (23·6%) for cases and controls, respectively]. Additionally, there was no difference in a proportion of dyspeptic H. pylori-positive subjects [59 (17·1%) versus 524 (15·1%)] between the case and control groups. Only 59 (17%) among the 347 IgAD patients underwent gastroscopy. A significantly larger proportion of case subjects experienced several forms of gastritis [13 (61·9%) versus 38 (21·6%), P < 0·001), duodenal ulcers [seven (33·3%) versus 19 (10·8%); P = 0·01] and nodular lymphoid hyperplasia (NLH) [two (9·5%) versus none; P = 0·011]. IgAD is not associated with increased prevalence of H. pylori-associated dyspepsia; nevertheless, H. pylori-infected dyspeptic IgAD subjects experience more EGD-proved gastritis, duodenal ulcers and NLH.
选择性免疫球蛋白A（IgA）缺乏症（IgAD）是西方世界最常见的原发性免疫缺陷病。本研究的目的是调查幽门螺杆菌感染的消化不良IgAD患者的患病率和临床特征。病例样本取自2004年至2014年期间因任何原因在Leumit医疗服务机构（以色列）进行血清总IgA测量且血清总IgA<0.07 g/l的所有12岁及以上受试者（n = 104729）。对照组由其余患者的随机样本组成，病例与对照的比例为1:10。使用特定的ICD-9-CM诊断代码从Leumit医疗保健服务电子数据库中识别并检索消化不良疾病。病例组包括347名受试者，对照组包括3470名受试者。消化不良患者的患病率无显著差异[病例组和对照组分别为84例（24.2%）和821例（23.6%）]。此外，病例组和对照组之间消化不良的幽门螺杆菌阳性受试者比例也无差异[分别为59例（17.1%）和524例（15.1%）]。347例IgAD患者中只有59例（17%）接受了胃镜检查。病例组中经历多种胃炎形式的受试者比例显著更高[13例（61.9%）对38例（21.6%），P<0.001]，十二指肠溃疡[7例（33.3%）对19例（10.8%）；P = 0.01]和结节性淋巴样增生（NLH）[2例（9.5%）对无；P = 0.011]。IgAD与幽门螺杆菌相关性消化不良的患病率增加无关；然而，幽门螺杆菌感染的消化不良IgAD受试者经上消化道内镜检查证实的胃炎、十二指肠溃疡和NLH更多。
