Wang Wei, Yao Tianhao, Zhang Tianyi, Quan Meiying, Wang Changyan, Wang Chen, Zhang Lejia, Tang Xiaoyan, Jian Shan, Song Hongmei
Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Colby College, Waterville, ME, USA.
Genes Dis. 2019 Oct 30;7(1):115-121. doi: 10.1016/j.gendis.2019.10.014. eCollection 2020 Mar.
Selective immunoglobulin A deficiency (SIgAD) is considered to be the most common human primary immune-deficiency disease in the world. However, the incidence in China is obviously lower than Caucasian races. The definition of SIgAD has changed over time with the progress of people's understanding. The scientific community did not reach a consensus on the definition until 1999. As a result, many previously reported cases need to be excluded under the current definition. SIgAD can lead to several spectra of diseases including infections and autoimmune diseases. We retrospectively summarized the SIgAD patients in Peking Union Medical College Hospital (PUMCH), and summarized the Chinese SIgAD reported in China and abroad in past 40 years. Fourty three SIgAD patients were confirmed in the study, in which 9 were healthy without clinical symptoms. Of the 34 patients with clinical symptoms, recurrent infections were found in 29 (85.3%) patients; 13 (38.2%) patients were with autoimmune diseases; 6 (17.6%)cases had allergic symptoms; 3 patients (8.8%) were with tumors, only one case (2.9%) had a family history. Compared with other countries, sIgAD patients in China showed similar symptoms, but the rate of recurrent infections and autoimmune diseases were higher than some other countries; most of the allergic symptoms are drug allergy, different with the allergic sequelae reported in other countries, such as asthma, rhinitis, food allergy and atopic dermatitis; and it is rare to have family history in Chinese patients. We also figured out that more female SIgAD patients tend to have more autoimmune diseases than men (P = 0.039).
选择性免疫球蛋白A缺乏症(SIgAD)被认为是世界上最常见的人类原发性免疫缺陷病。然而,中国的发病率明显低于白种人。随着人们认识的进步,SIgAD的定义也在不断变化。直到1999年,科学界才在定义上达成共识。因此,许多先前报道的病例根据当前定义需要被排除。SIgAD可导致多种疾病,包括感染和自身免疫性疾病。我们回顾性总结了北京协和医院的SIgAD患者,并总结了过去40年国内外报道的中国SIgAD病例。本研究共确诊43例SIgAD患者,其中9例健康无临床症状。在34例有临床症状的患者中,29例(85.3%)有反复感染;13例(38.2%)患有自身免疫性疾病;6例(17.6%)有过敏症状;3例(8.8%)患有肿瘤,只有1例(2.9%)有家族史。与其他国家相比,中国的SIgAD患者症状相似,但反复感染和自身免疫性疾病的发生率高于其他一些国家;大多数过敏症状为药物过敏,与其他国家报道的过敏后遗症如哮喘、鼻炎、食物过敏和特应性皮炎不同;中国患者很少有家族史。我们还发现,女性SIgAD患者比男性更容易患自身免疫性疾病(P = 0.039)。