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Clinical significance of hyper-IgA in a paediatric laboratory series
  1. Valentina Copetti1,
  2. Serena Pastore1,2,
  3. Carlo De Pieri2,
  4. Oriano Radillo3,
  5. Andrea Taddio1,2,
  6. Alessandro Ventura1,2,
  7. Alberto Tommasini2
  1. 1University of Trieste, Trieste, Italy
  2. 2Institute of Maternal and Child Health—IRCCS Burlo Garofolo, Trieste, Italy
  3. 3Department of Advanced Diagnostic and Clinical Trials, Institute for Maternal and Child Health—IRCCS Burlo Garofolo, Trieste, Italy
  1. Correspondence to Dr Serena Pastore, University of Trieste, Institute of Maternal and Child Health—IRCCS Burlo Garofolo Trieste, via dell'Istria 65/1, Trieste, 34137 Italy; pastore_serena{at}


The causes of extremely elevated IgA, whether isolated or associated with an increase in other classes of immunoglobulin, are poorly defined in paediatrics. We reviewed the diagnostic significance of very high IgA levels (greater than 3 SD above the mean for age) in a cohort of patients referred to a tertiary care children's hospital. Hyper-IgA was found in 91 of 6364 subjects (1.4%) and in 68 cases was not associated with an increased IgG and/or IgM level. Most subjects with hyper-IgA (73.5%) had a severe immune defect, a chronic rheumatic disease or inflammatory bowel disease, while these conditions were very rare in a control group with normal IgA values (8%). Although our results may in part reflect the experience of a tertiary care centre, we suggest that hyper-IgA in children should always arouse suspicion of a serious disease.

  • General Paediatrics
  • Immunology
  • Paediatric Practice

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