Miwa Y, Negishi M, Hanaoka R, Hatano Y, Iwabuchi H, Kanemitu H, Kaga S, Hashimoto M, Kasama T, Ide H, Shimada E, Tadokoro K
First Department of Internal Medicine, Showa University School of Medicine, Tokyo.
Ryumachi. 1998 Oct;38(5):735-40.
We described a case of rheumatoid arthritis (RA) with selective IgA deficiency. A 69 year-old female with RA was admitted because of gall bladder cancer, and also had selective IgA deficiency which serum IgA level was less than 5.0 mg/dl, and IgA 1 and IgA 2 subclasses were not detected. Prior to the operation, she was given red cell compatible blood transfusion because of severe anemia. After 30 min of transfusion, she developed chill, nausea, vomiting and hypotension. These anaphylactic reactions might be induced by the presence of anti-IgA antibody, since the level of this antibody titers in her serum was elevated, assessed by the methods of ELISA and Western blotting. Although a case of RA associated with selective IgA deficiency, and also with elevated serum anti-IgA antibody level is extremely uncommon, attention should be paid to the presence of anti-IgA antibody in patients with selective IgA deficiency to avoid any unexpected anaphylactic reactions.
我们描述了一例伴有选择性IgA缺乏症的类风湿关节炎（RA）病例。一名69岁患RA的女性因胆囊癌入院，同时患有选择性IgA缺乏症，其血清IgA水平低于5.0mg/dl，且未检测到IgA 1和IgA 2亚类。手术前，由于严重贫血，她接受了红细胞相容性输血。输血30分钟后，她出现寒战、恶心、呕吐和低血压。这些过敏反应可能是由抗IgA抗体的存在引起的，因为通过ELISA和Western印迹法评估，她血清中该抗体的滴度水平升高。尽管RA病例伴有选择性IgA缺乏症且血清抗IgA抗体水平升高极为罕见，但对于选择性IgA缺乏症患者，应注意抗IgA抗体的存在，以避免任何意外的过敏反应。
