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August 16, 1985

IgA Deficiency and AIDS

Author Affiliations

Henry Ford Hospital Detroit

JAMA. 1985;254(7):912. doi:10.1001/jama.1985.03360070050020

To the Editor.—  We have documented 25 cases of acquired immunodeficiency syndrome (AIDS) at our institution since 1982, and two of these patients have had absent serum IgA. Both patients were adult male homosexuals with lymphadenopathy and had reversal of their T-helper/suppressor ratios (0.1 and 0.2, respectively, with a norm for this institution of 2.0). Both developed skin lesions diagnosed as Kaposi's sarcoma on biopsy. Both had medical histories of chronic sinusitis, and one had recurrent cutaneous infections as well. Although serum immunoglobulin levels were not determined prior to their manifestations of AIDS or pre-AIDS, IgA deficiency has not been shown to be a component of the AIDS syndrome itself. In fact, levels of serum immunoglobulins including IgA are usually elevated in AIDS.1The prevalence of selective IgA deficiency in a large general population study in this area was found to be approximately one in 1,000.2 This is