Selective IgA deficiency associated with allergy to cow's milk protein, case report
-
1
Universidad de Antioquia, Colombia
Background: IgA is the most abundant immunoglobulin in the human; it is found in tissues and in secretions especially from the gastrointestinal tract reflecting its role in mucosal immunity and the development of tolerance. Selective IgA deficiency (<10mg/dl) is the most common primary immunodeficiency, most patients with IgA deficiency are asymptomatic so its clinical significance is unknown, although it has been associated with increased incidence of some autoimmune and allergic diseases, being food allergy and asthma most frequently related. The protein allergy to cow's milk is one of the most prevalent and important food allergies in childhood. In patients with allergy to proteins in cow's milk have been shown a decrease in the production of TGF-β, one of the main cytokines that stimulate the production of IgA by B cells, a mechanism that could also be explaining the relationship between allergy to the protein in cow's milk with selective IgA deficiency.
Objective: To report a case of protein allergy to cow's milk in the presence of IgA deficiency.
Methods: Case Report
Results: Patient 5 years of age, female, personal history of recurrent infections, rhinitis and Asthma, with colic pain since three years of age that is increased with cow milk intake, tolerate forms extensively cooked. Treatments: Salmeterol/Fluticasone 25-125 every 12 hours. Montelukast 4 mg daily, 100mg daily Mometasone Furoate. Paraclinical: IgA: 0.4 (20-358), IgG: 999, IgM 132.4, specific IgE for casein 4.5 IU/ml (class 3), Alpha-lactalbumin 2.98 (Class 2) Whole cow's milk 2.82 (Class 2), beta-lactoglobulin 0 (Class 0), dog dander 2.2 (Class 2). Prick test negative, albumin 4.8. Avoidance of cow's milk is recommended. During follow-up the patient gradually decreases levels of specific IgE to cow's milk protein, Tolerating lactose-free formulas to 7 years, with a slight increase in levels of IgA (13.9mg/dl).
Conclusion: This case illustrates a clear association between selective IgA deficiency and food allergy which has been previously described in the literature, specifically in our patient allergic to cow's milk protein.
References
1. Autoimmunity Reviews. 2014; 13 (2014) 163–177.
2. Ann Allergy Asthma Immunol.2003; 90 (Suppl 3):81– 83.
3. Clinical Immunology. 2009; 133, 78–85.
Keywords:
deficit IgA,
Allergy to cow's milk protein,
food allergy,
immunodeficiencies,
case report
Conference:
IMMUNOCOLOMBIA2015 - 11th Congress of the Latin American Association of Immunology - 10o. Congreso de la Asociación Colombiana de Alergia, Asma e Inmunología, Medellin, Colombia, 13 Oct - 16 Oct, 2015.
Presentation Type:
Poster Presentation
Topic:
Allergy
Citation:
Gómez Henao
CM,
Herrera Morales
CI,
Celis Henao
AM and
Chinchilla Mejía
CF
(2015). Selective IgA deficiency associated with allergy to cow's milk protein, case report.
Front. Immunol.
Conference Abstract:
IMMUNOCOLOMBIA2015 - 11th Congress of the Latin American Association of Immunology - 10o. Congreso de la Asociación Colombiana de Alergia, Asma e Inmunología.
doi: 10.3389/conf.fimmu.2015.05.00269
Copyright:
The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers.
They are made available through the Frontiers publishing platform as a service to conference organizers and presenters.
The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated.
Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed.
For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions.
Received:
15 May 2015;
Published Online:
14 Sep 2015.
*
Correspondence:
Dr. Catalina M Gómez Henao, Universidad de Antioquia, Medellín, Colombia, catago13@hotmail.com