Cerutti F, Urbino A, Sacchetti C, Palomba E, Zoppo M, Tovo P A
Istituto di Clinica Pediatrica dell'Università degli Studi di Torino, Italia.
Pediatr Med Chir. 1988 Mar-Apr;10(2):197-201.
Variation of serum immunoglobulin (Ig) levels and increased frequency of selective IgA deficiency are frequently associated with autoimmune diseases. In insulin-dependent diabetes mellitus (I.D.D.M.) pathogenesis autoimmunity is known to play a causative role. Aim of the present study was to evaluate serum major immunoglobulin subclasses levels and frequency of IgA selective deficiency in juvenile onset I.D.D.M. IgG, IgA, IgM concentrations were determined in 191 insulin-dependent children and adolescents (100 males, 91 females; mean age 10.6 divided by 4.8 yrs; mean duration of I.D.D.M. 5.7 divided by 3.9 yrs) and in 180 age-matched healthy controls. Mean Ig levels were comparable among both group. Duration of I.D.D.M. did not affect mean serum Ig levels. Selective IgA deficiency was found in 7 on 191 diabetics: this gives a prevalence of the defect of 1:27, which is higher than in the Italian pediatric population (1:500). HLA typing evidenced 2 DR3 positive patients, 2 DR4, 1 B8-DR3 and 1 B8-DR3/DR4. The significance of selective IgA deficiency in I.D.D.M. is discussed.
血清免疫球蛋白（Ig）水平的变化以及选择性IgA缺乏症的频率增加常常与自身免疫性疾病相关。在胰岛素依赖型糖尿病（I.D.D.M.）的发病机制中，自身免疫被认为起着致病作用。本研究的目的是评估青少年起病的I.D.D.M.患者血清主要免疫球蛋白亚类水平以及IgA选择性缺乏的频率。对191名胰岛素依赖型儿童和青少年（100名男性，91名女性；平均年龄10.6±4.8岁；I.D.D.M.平均病程5.7±3.9年）和180名年龄匹配的健康对照者测定了IgG、IgA、IgM浓度。两组的平均Ig水平相当。I.D.D.M.的病程不影响血清平均Ig水平。在191名糖尿病患者中有7人发现选择性IgA缺乏：该缺陷的患病率为1:27，高于意大利儿科人群（1:500）。HLA分型显示2例DR3阳性患者、2例DR4、1例B8-DR3和1例B8-DR3/DR4。讨论了I.D.D.M.中选择性IgA缺乏的意义。
