Branigan E F, Stevenson M M, Charles D
Obstet Gynecol. 1983 Mar;61(3 Suppl):47S-49S.
Selective deficiency of serum IgA is the most common immunodeficiency in humans; when immunodeficient individuals receive blood transfusions a severe anaphylactoid reaction can develop. The present report describes such a patient. After the transfusion reaction a hemagglutination inhibition assay revealed that her blood contained less than 1.0 micrograms/ml of IgA and an anti-IgA antibody that reacted with the 2 IgA proteins, isotypes IgA1 and IgA2. Immediately after the reaction the patient's serum anti-IgA antibody titer was 1:16,384, and when reevaluated 5 weeks later it was 1:8000. All 3 of her children were shown to be IgA deficient, and 2 of them had antibodies against IgA2. This type of anaphylactoid reaction can be avoided by transfusing blood from IgA-deficient donors, frozen deglycerolized red cells, or red cells that have been washed several times to extract all IgA proteins.
选择性血清IgA缺乏是人类最常见的免疫缺陷；免疫缺陷个体接受输血时可能会发生严重的类过敏反应。本报告描述了这样一位患者。输血反应后，血凝抑制试验显示她的血液中IgA含量低于1.0微克/毫升，并且有一种抗IgA抗体可与两种IgA蛋白（即IgA1和IgA2同种型）发生反应。反应后立即检测，患者血清抗IgA抗体效价为1:16,384，5周后重新评估时为1:8000。她的3个孩子均显示IgA缺乏，其中2个有抗IgA2抗体。通过输注来自IgA缺乏供体的血液、冷冻去甘油红细胞或经过多次洗涤以去除所有IgA蛋白的红细胞，可以避免这种类过敏反应。
