Secretory IgA deficiency in pediatric patients: clinical and laboratory follow-up.

: This is a prospective three-year (1985-1988) clinical and laboratory follow-up study of 43 pediatric patients without any measurable secretory IgA, intending to describe the their natural course. We also intended to detect evidence which may allow to predict their future outcome, whether they would become asymptomatic or end up developing chronic disease. A direct statistical correlation was found between those patients who normalize their secretory IgA levels and their course in an asymptomatic state. Thus, if a child does not have any sIgA at all, the relative risk to get sick is 0.86 (86%), while in those having sIgA within normal ranges, the relative risk of disease decreases to 0.46 (46%), representing a p value less than or equal to 0.05. Among the analyzed variables and their influence on the fact that a patient may or may not synthesize sIgA, none of them showed a predictive value for bronchial asthma by itself. However, when sIgA and total serum IgE levels, were analyzed together (being the two variables demonstrating to influence), the probability of becoming asthmatic is much greater in the ones with elevated total serum IgE and absent sIgA. This group is significantly different from the one with normal IgE and sIgA levels (p less than or equal to 0.001). According to our experience in evaluating and controlling a pediatric patient with repeated episodes of bronchial obstruction and lacking sIgA, an immediate strict environmental control should be established in order to avoid all possible contacts with allergens.(ABSTRACT TRUNCATED AT 250 WORDS)