M Matsuda Kazuki, Arioka Hiroko, Kobayashi Daiki
Division of General Internal Medicine, Department of Medicine, St. Luke's International Hospital, Tokyo, Japan.
Center for Clinical Epidemiology, St. Luke's International Hospital, Tokyo, Japan.
Cent Eur J Immunol. 2020;45(2):189-194. doi: 10.5114/ceji.2020.97908. Epub 2020 Jul 27.
Partial IgA deficiency (pIgAD), including selective IgA deficiency, is one of the most common types of immunodeficiency. Early detection is crucial to prevent complications, such as recurrent infections and anaphylactic reactions to blood derivatives.
Useful screening methods have not yet been established. We conducted a single-center retrospective observational study, with low serum IgA patients to clarify the risk factors of pIgAD among patients with low serum levels of IgA. All patients with low serum IgA levels treated in our outpatient clinic from April 2010 to March 2016 were retrospectively reviewed using electronic medical records. We performed tests and Student's t-tests for the univariate analysis, logistic regression analysis using the multiple imputation method for the multivariate analysis, and receiver operating characteristic (ROC) curve analysis.
The univariate analysis showed statistically significant differences between the pIgAD group and the non-pIgAD group in age, gender, blood cell counts, serum protein levels, and renal function tests. The multivariate analysis revealed that female gender, a white blood cell counts lower than 10,000/µl, and a hemoglobin level of 10.0-15.0 g/dl are predictive factors of pIgAD.
After estimating any missing data using the multiple imputation method, age younger than 60 years old was also statistically significant. ROC curve analysis confirmed the validity of the model used in our multivariate analysis. When clinicians encounter low serum IgA patients who are female, of younger age, and have normal blood cell counts, and hemoglobin levels, they should suspect the existence of pIgAD.
部分IgA缺乏症(pIgAD),包括选择性IgA缺乏症,是最常见的免疫缺陷类型之一。早期检测对于预防并发症至关重要,如反复感染和对血液制品的过敏反应。
尚未建立有效的筛查方法。我们进行了一项单中心回顾性观察研究,纳入血清IgA水平低的患者,以阐明血清IgA水平低的患者中pIgAD的危险因素。使用电子病历对2010年4月至2016年3月在我们门诊接受治疗的所有血清IgA水平低的患者进行回顾性分析。我们进行了检验和学生t检验用于单变量分析,使用多重填补法进行逻辑回归分析用于多变量分析,并进行了受试者工作特征(ROC)曲线分析。
单变量分析显示,pIgAD组和非pIgAD组在年龄、性别、血细胞计数、血清蛋白水平和肾功能检查方面存在统计学显著差异。多变量分析显示,女性、白细胞计数低于10,000/µl以及血红蛋白水平为10.0 - 15.0 g/dl是pIgAD的预测因素。
使用多重填补法估计任何缺失数据后,年龄小于60岁也具有统计学显著性。ROC曲线分析证实了我们多变量分析中使用的模型的有效性。当临床医生遇到血清IgA水平低、为女性、年龄较小且血细胞计数和血红蛋白水平正常的患者时,应怀疑存在pIgAD。