From the Guidelines
Elevated Immunoglobulin A (IgA) levels can indicate a range of underlying conditions, including autoimmune disorders, chronic infections, liver diseases, and certain cancers, and require prompt medical evaluation to determine the underlying cause and appropriate treatment. The implications of elevated IgA levels are varied and can be associated with several clinical conditions. According to the study by 1, autoimmune hepatitis (AIH) is a clinically distinct syndrome characterized by a large heterogeneity of clinical, laboratory, and histological manifestations, and elevated IgA levels can be one of the laboratory features of this condition. However, the study does not specifically focus on the implications of elevated IgA levels.
In contrast, the study by 1 provides more information on the implications of IgA deficiency rather than elevation. It states that patients with selective IgA deficiency (SIGAD) should be monitored over time for the occurrence of complications, which can include respiratory and gastrointestinal tract infections, atopy, autoimmune diseases, celiac disease, and malignancy.
Given the available evidence, it is essential to consult with a healthcare provider to determine the underlying cause of elevated IgA levels, as treatment targets the underlying condition rather than the elevated IgA itself. The healthcare provider may recommend additional testing, such as complete blood count, comprehensive metabolic panel, urinalysis, and possibly specialized tests like serum protein electrophoresis or tissue biopsies, depending on the symptoms.
Some possible underlying conditions that may cause elevated IgA levels include:
- Chronic infections
- Autoimmune disorders like IgA nephropathy or celiac disease
- Liver diseases such as alcoholic cirrhosis
- Certain cancers like multiple myeloma or IgA monoclonal gammopathy Treatment of elevated IgA levels should focus on addressing the underlying condition, and may involve medications, lifestyle changes, or other interventions as needed. For example, if the elevated IgA levels are caused by celiac disease, a gluten-free diet would be recommended, while if due to infection, appropriate antimicrobials would be prescribed.
Overall, elevated IgA levels can have significant implications for patient health, and prompt medical evaluation and treatment are essential to prevent complications and improve outcomes.
From the Research
Implications of Elevated Immunoglobulin A (IgA) Levels
Elevated IgA levels have been associated with various clinical implications, including:
- Predicting earlier proteinuria remission in IgA nephropathy patients 2
- Being a marker of immune deficiency, such as selective antibody deficiency syndrome 3
- Indicating a serious disease, such as severe immune defect, chronic rheumatic disease, or inflammatory bowel disease, in pediatric patients 4
- Being a diagnostic utility in alcoholic liver disease and associated with liver fibrosis in steatotic liver disease 5
- Being associated with mild inflammation, sufficient disease-specific features, and favourable responses to treatments in patients with IgG4-related disease 6
Clinical Associations
Elevated IgA levels have been clinically associated with:
- Increased serum IgG, ratio of IgA/C3, and recurrent mucosal infection rate in IgA nephropathy patients 2
- Hyper-IgD syndrome, although the lack of antibody response to vaccines is atypical of this syndrome 3
- Severe immune defects, chronic rheumatic diseases, or inflammatory bowel diseases in pediatric patients 4
- Liver fibrosis, diabetes, and increased visceral fat level in patients with steatotic liver disease 5
- Mild inflammation, sufficient disease-specific features, and favourable responses to treatments in patients with IgG4-related disease 6
Diagnostic Utility
Elevated IgA levels may serve as a diagnostic utility in:
- Predicting proteinuria remission in IgA nephropathy patients 2
- Identifying immune deficiencies, such as selective antibody deficiency syndrome 3
- Diagnosing serious diseases, such as severe immune defects, chronic rheumatic diseases, or inflammatory bowel diseases, in pediatric patients 4
- Assessing liver disease severity in patients with steatotic liver disease 5
- Characterizing a subgroup of patients with IgG4-related disease who have a good response to glucocorticoids and less frequent relapse 6