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Subject: Immunoglobulin A (IgA)
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IgA makes up the majority of immunoglobulin in mucosal secretions, including nasal and pulmonary secretions, saliva and intestinal fluids, tears, and secretions of the genitourinary tract. IgA is important in preventing attachment or penetration of the body surfaces by microorganisms, and in protection against respiratory, GI, and GU infections. IgA cannot cross the placenta. It can be produced by infants, and their secretions tend to be typically low. IgA is the second most frequent type of monoclonal immunoglobulin identified in multiple myeloma.
Normal ranges: see Table 16.41.
Detection or monitoring of monoclonal gammopathies and immune deficiencies
Assist in the diagnosis of multiple myeloma
Monitor therapy for multiple myeloma
Evaluate patients suspected of IgA deficiency prior to transfusion
Evaluate anaphylaxis associated with the transfusion of blood and blood products (anti-IgA antibodies may develop in patients with low levels of IgA, possibly resulting in anaphylaxis when donated blood is transfused)
Cirrhosis of the liver
Chronic inflammatory diseases
Inflammatory bowel disease
RA with high titers of RF
SLE (some patients)
Mixed connective tissue diseases
Sarcoidosis (some patients)
IgA myeloma (M component)
Alpha-heavy chain disease
Chronic lymphocytic leukemia
Normal persons (1:700)
Hereditary telangiectasia (80% of patients)
Type III dysgammaglobulinemia
Malabsorption (some patients)
Cirrhosis of the liver (occasionally)
Still disease (occasionally)
Recurrent otitis media (occasionally)
Immunochemical methods do not distinguish between polyclonal and monoclonal levels. Serum protein electrophoresis and immunofixation need to be performed for quantification of M-proteins.