Selective IgA deficiency associated with allergy to cow's milk protein, case report

Abstract

Event Abstract Back to Event Selective IgA deficiency associated with allergy to cow's milk protein, case report Catalina M. Gómez Henao1*, Cristina I. Herrera Morales1, Ana M. Celis Henao1 and Carlos F. Chinchilla Mejía1 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.