PT - JOURNAL ARTICLE AU - Copetti, Valentina AU - Pastore, Serena AU - De Pieri, Carlo AU - Radillo, Oriano AU - Taddio, Andrea AU - Ventura, Alessandro AU - Tommasini, Alberto TI - Clinical significance of hyper-IgA in a paediatric laboratory series AID - 10.1136/archdischild-2014-306607 DP - 2014 Dec 01 TA - Archives of Disease in Childhood PG - 1114--1116 VI - 99 IP - 12 4099 - http://adc.bmj.com/content/99/12/1114.short 4100 - http://adc.bmj.com/content/99/12/1114.full SO - Arch Dis Child2014 Dec 01; 99 AB - 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.