Materiały źródłowe

• #1 Selective IgA deficiency | Immune Deficiency Foundation

  https://primaryimmune.org/understanding-primary-immunodeficiency/types-of-pi/selective-iga-deficiency

  An ideal treatment for SIgAD would be to replace IgA. However, no IgA-enriched immunoglobulin (Ig) preparation is available in the U.S. Treatment should be directed toward a specific illness. For example, individuals with chronic or recurrent infections need treatment with appropriate antibiotics. Ideally, antibiotic therapy should be targeted at the specific organism causing the infection. It is not always possible, however, to identify these organisms and their antibiotic sensitivities precisely, and therefore, the use of broad-spectrum antibiotics may be indicated. Certain individuals who have chronic sinusitis or chronic bronchitis may need to stay on long-term preventive antibiotic therapy (antibiotic prophylaxis). In these cases, the healthcare provider and person with SIgAD need to discuss the benefits and risks of the various possibilities and reach a mutual agreement regarding treatment.

• #2 Selective IgA Deficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538205/

  Due to the heterogeneity of the selective IgA deficiency and the fact that there is no specific treatment, every patient requires individual management. The recommended management comprises periodic monitoring, prophylaxis, and treatment of infections with antibiotics (sometimes empirically), treatment of the associated allergic and autoimmune conditions, replacement therapy with intravenous or subcutaneous immunoglobulins (rare), and patient education. Many sources recommend directing empiric antibiotic therapy specifically toward Streptococcus pneumoniae and Haemophilus influenza. Immunoglobulin replacement should be performed judiciously and cautiously to avoid an anaphylactic reaction. […] All IgA deficient patients, even if asymptomatic, should receive polyvalent pneumococcal and influenza vaccines; patients must avoid attenuated or live vaccines. Specifically, live vaccines such as oral polio, Bacille-Calmette-Guerin, and yellow fever, should be considered contraindicated due to the threat of subsequent severe infection.

• #3 Selective IgA Deficiency: Epidemiology, Pathogenesis, Clinical Phenotype, Diagnosis, Prognosis and Management – PubMed

  https://pubmed.ncbi.nlm.nih.gov/27763681/

  Selective immunoglobulin A deficiency (SIgAD) is the most common primary antibody deficiency. […] There is no specific treatment for patients with symptomatic IgA deficiency, although prophylactic antibiotic therapy along with circumstantial immunoglobulin replacement with justification and supportive care (using a product that contains minimal IgA) could be helpful for patients with a severe phenotype. […] The epidemiology, pathogenesis, clinical phenotype, diagnosis, prognosis, management and treatment in patients with SIgAD have been reviewed.

• #4 HIE Multimedia – Selective deficiency of IgA

  https://adamcertificationdemo.adam.com/content.aspx?productid=117&pid=1&gid=001476

  No specific treatment is available. Some people gradually develop normal levels of IgA without treatment. […] Treatment involves taking steps to reduce the number and severity of infections. Antibiotics are often needed to treat bacterial infections. […] For people with more frequent or severe infections, immunoglobulins might be given through a vein or by injection to boost the immune system. […] Autoimmune disease treatment is based on the specific problem. […] Note: People with complete IgA deficiency may develop anti-IgA antibodies if given blood products and immunoglobulins. This may lead to allergies or life-threatening anaphylactic shock. However, they can safely be given IgA-depleted immunoglobulins.

• #5 Selective Immunoglobulin A (IgA) Deficiency – Immune Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/immune-disorders/immunodeficiency-disorders/selective-immunoglobulin-a-iga-deficiency

  Antibiotics are used to treat or sometimes to prevent infections. […] Usually, no treatment of selective IgA deficiency is needed. […] Antibiotics are given to people who have an infection. If the disorder is severe, antibiotics are given in advance to prevent infections from developing. […] People who have had an anaphylactic reaction to a blood transfusion or immune globulin should wear medical identification to alert doctors to take precautions against such reactions. […] Selective IgA deficiency that results from taking a medication usually resolves if the medication is stopped.

• #6 Selective IgA deficiency – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/selective-iga-deficiency/diagnosis-treatment/drc-20450490

  Antibiotic treatments are prescribed as needed to treat bacterial disease. If you have had a long-term illness, such as chronic bronchitis, you may receive antibiotics as a preventive treatment. This therapy is called antibiotic prophylaxis (pro-fuh-LAK-sis). […] What are possible treatment plans?

• #7 Immunoglobulin A Deficiency Medication: Vaccines, inactivated bacteria

  https://emedicine.medscape.com/article/136580-medication

  Immunoglobulin A deficiency (IgAD) has no specific treatment. Replacement therapy is not practical for IgAD because of the short half-life of IgA and the relative paucity of IgA in commercial immunoglobulin preparations. […] Antibiotic therapy is the first line of treatment, specific for sinopulmonary or GI tract infections. Associated sinopulmonary infections are treated according to treatment protocols used for community-acquired respiratory tract infections in healthy persons, but prolonged treatment may be necessary. […] Use of IGIV as replacement therapy is not indicated for selective IgAD per se. In selected circumstances in patients with concomitant SIgAD and selective IgG antibody deficiency who have recurrent or chronic high-grade sinopulmonary infections, a trial of IGIV may be given to see if a substantial clinical response occurs. Most patients with IgAD as part of CVID and/or with concomitant specific IgG antibody deficiency can safely receive intravenous (IV) or subcutaneous (SC) IgG replacement therapy. […] Precautions must be used in the administration of IV immunoglobulin and other blood products in patients with IgAD because IV immunoglobulin preparations and other blood products contain at least small amounts of IgA.

• #8 Selective IgA Deficiency in Children: Clinical Manifestations, Evaluation, and Management

  https://www.contemporarypediatrics.com/view/selective-iga-deficiency-children-clinical-manifestations-evaluation-and-management

  Selective IgA deficiency (SIGAD) is the most common immunodeficiency disorder; it affects about 1 in 200 to 900 persons. Most affected children are asymptomatic. […] Patients with SIGAD who have significant recurrent upper respiratory tract infections may benefit from a 6-month course of prophylactic antibiotics. These antibiotics may be continued if the initial course is successful. Some children with SIGAD who have seasonal patterns of infections may benefit from receiving prophylactic antibiotics only during the winter months. […] A small number of patients with SIGAD continue to have recurrent infections despite antibiotic prophylaxis. These patients may be treated with immunoglobulin replacement therapy; however, use of this treatment remains controversial. […] All children with SIGAD should be immunized according to the same schedule used for children without SIGAD and should receive the annual influenza vaccine. Most patients with SIGAD have an uncomplicated clinical course. However, continued long-term follow-up to identify other immunological abnormalities, such as CVID, autoimmune disease, and malignancy, is required.

• #9 Selective IgA Deficiency

  https://www.aaaai.org/conditions-treatments/primary-immunodeficiency-disease/selective-iga-deficiency

  Selective IgA deficiency is the most common primary immunodeficiency disease (PIDD). […] The underlying cause for Selective IgA Deficiency is unknown and there is currently no way to replace IgA in the body. […] Unlike many other immunoglobulin deficiencies, the condition is not treated with immunoglobulin replacement therapy. […] In cases where recurrent infections are a problem, preventative antibiotics may be used to help diminish the frequency of infections. Individuals with IgA deficiency often require a longer course of antibiotics for infections to clear up. Selective IgA deficiency can also predispose individuals to have allergic-like or anaphylactic reactions to blood transfusions or infusions of certain blood products. If you have an IgA deficiency, be certain to notify your healthcare provider so you receive modified blood products if necessary.

• #10 Selective IgA Deficiency – Immunology; Allergic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/immunology-allergic-disorders/immunodeficiency-disorders/selective-iga-deficiency

  Treatment is antibiotics as needed (sometimes prophylactically) and usually avoidance of blood products that contain IgA. […] Antibiotics as needed for treatment and, in severe cases, for prophylaxis. […] Avoidance of blood products that contain IgA. […] Allergic manifestations are treated. Antibiotics are given as needed for bacterial infections of the ears, sinuses, lungs, or gastrointestinal or genitourinary tracts. In severe cases, antibiotics are given prophylactically. […] Because immune globulin replacement therapy contains mostly IgG and minimal amounts of IgA, patients with IgA deficiency do not benefit from it. However, there still is some risk of sensitizing patients to IgA or triggering an anaphylactic reaction in those who previously developed anti-IgA antibodies. Rarely, if patients have no antibody response to vaccines and if prophylactic antibiotics are ineffective in preventing infection, specially formulated immune globulin preparations that contain extremely low levels of IgA can be tried and may be somewhat effective.

• #11 Immunoglobulin A Deficiency Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/136580-treatment

  Per the CDC, patients with IgAD are recommended to receive the pneumococcal Hib (for children aged 12-59 months) and recombinant zoster vaccines given their specific risks for infection. Vaccine contraindications in IgAD patients include the OPV, BCG, DEN4CYD, and yellow fever vaccines. Other live vaccines appear to be safe. […] Prophylactic therapy for selective IgA deficiency.

• #11 Immunoglobulin A Deficiency Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/136580-treatment

  The approach to treatment of immunoglobulin A deficiency (IgAD) includes identification of comorbid conditions, preventive measures to reduce the risk of infection, and prompt, rigorous, and effective treatment of infections. Functional endoscopic sinus surgery can frequently help relieve chronic obstruction and promote drainage. Tympanostomy tubes may also be helpful in reducing the risk of decreased hearing and secondary defective speech development in children with chronic suppurative otitis related to antibody deficiency. […] Some patients with recurrent sinusitis require surgical intervention to promote drainage. […] Dietary modifications may be necessary to manage chronic diarrhea and malabsorption or food allergy in patients with immunoglobulin A deficiency (IgAD). A gluten-free diet and, possibly, other restricted diets are important for treatment in patients with celiac disease or who have IgG antibodies to animal proteins in milk or other foods.

• #12 Selective IgA deficiency – Immunodeficiency UKAccessibilityIncrease TextDecrease TextGrayscaleHigh ContrastNegative ContrastLight BackgroundLinks UnderlineReadable FontReset

  https://www.immunodeficiencyuk.org/selective-iga-deficiency-2/

  Most people with sIgAD do not require treatment or regular immunology review. Infections should be treated promptly with antibiotics, especially sinusitis, chest infections or diarrhoea. In rare cases, longer courses of antibiotics may be needed to prevent infections from coming back. […] As in people who have healthy immune systems, recurrent sinusitis in sIgAD patients can be made worse by poor drainage of the sinuses. Obtaining the advice of an ear, nose and throat (ENT) specialist is often helpful to prevent further infections. Steroid nasal sprays may help to control ENT symptoms. […] People with sIgAD who also do not respond to vaccination might benefit from immunoglobulin replacement therapy. This is done on a trial basis for one year in order to assess the clinical benefit in the patient as there is no published data available to advise on this treatment otherwise. […] Most vaccines are safe to be administered to patients with sIgAD, provided that other tests of immune function are normal. The infant and childhood vaccination schedule can be followed as normal. Vaccinations required in adulthood can be discussed with your clinical immunology team.

• #13 Selective IgA deficiency | Immune Deficiency Foundation

  https://primaryimmune.org/understanding-primary-immunodeficiency/types-of-pi/selective-iga-deficiency

  People with SIgAD (7 mg/dL) are often considered to be at increased risk of life-threatening allergic reactions, also known as an anaphylactic reaction, to blood and blood products, including immunoglobulin (Ig) replacement therapy that may contain traces of IgA. This is thought to be due to antibodies (IgE) against the IgA antibody, which may be found in some IgA-deficient individuals. These reactions, however, are very rare overall. […] If individuals with SIgAD and IgG2 subclass deficiency have a history of recurrent serious infections, a trial of Ig replacement therapy may be used to prevent infections. If there is a concern about the risk of adverse reactions because of the small amounts of IgA in intravenous immunoglobulin (IVIG) preparations, then it is advised to use subcutaneous immunoglobulin (SCIG). The latter is preferred over low IgA-containing preparations administered intravenously because of the following reasons: there is only one IVIG preparation with extremely low IgA, infusions need to be given in a hospital setting and under medical supervision, and anaphylactic reaction to SCIG has not been reported. Individuals with SIgAD who need a blood transfusion should receive washed red cells to remove the plasma that contains the IgA that may cause a transfusion reaction. […] As for autoimmune diseases, a variety of therapeutic options exist, such as anti-inflammatory drugs, steroids, or biological drugs. As with every treatment, the individual and/or caregiver and their healthcare provider should discuss the treatment plan and best treatment options.

• #14 Can You Use IVIG For IgA Deficiency? – AmeriPharma® Specialty Care

  https://ameripharmaspecialty.com/ivig/can-you-use-ivig-for-iga-deficiency/

  Though not usually recommended, specially formulated IVIG preparations may be an option for people with severe IgA deficiency who are unresponsive to vaccines and antibiotics. […] IVIG therapy is not the primary treatment for IgA deficiency. Nonetheless, it may be an option if vaccines and antibiotics don’t work. […] The use of IVIG for IgA deficiency is somewhat controversial. IVIG products contain varying amounts of IgA, which can trigger potentially life-threatening allergic reactions in some IgA-deficient people. […] However, some studies suggest that anti-IgA antibodies may not be as crucial to causing side effects as previously thought. […] Subcutaneous IG (SCIG) or IVIG preparations with low amounts of IgA are ideal for IgA-deficient people, as they carry a lower risk of serious side effects.

• #15 Can You Use IVIG For IgA Deficiency? – AmeriPharma® Specialty Care

  https://ameripharmaspecialty.com/ivig/can-you-use-ivig-for-iga-deficiency/

  It might be possible for you to receive IVIG (even if you are IgA-deficient) for other conditions. […] When using IVIG for IgA deficiency or other immunodeficiencies, it is best to use a product with low IgA. […] IVIG for IgA deficiency is not typically recommended. […] In rare cases, IVIG may be considered if vaccines and antibiotics fail to work. […] All IVIG products mention on their label that they are contraindicated in IgA-deficient people with antibodies against IgA and a history of allergy. However, this is not an absolute contraindication. The ultimate decision to use (or avoid) IVIG for IgA deficiency depends on whether the benefits outweigh the potential risks.

• #16 Selective IgA Deficiency – Immunology; Allergic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/immunology-allergic-disorders/immunodeficiency-disorders/selective-iga-deficiency

  Blood products that contain IgA are avoided in patients with IgA deficiency because IgA can elicit an anti-IgA-mediated anaphylactic reaction. If transfusion of red blood cells (RBCs) is needed, only washed packed RBCs can be used. If other blood components are needed, they should be IgA-deficient, and cellular components should be washed. […] Patients with selective IgA deficiency are advised to wear medical identification to prevent inadvertent plasma or immune globulin administration, which could lead to anaphylaxis. […] Give antibiotics as needed and, in severe cases, prophylactically. […] Avoid giving patients blood products or immune globulin that contain more than minimal amounts of IgA.

• #17 IgA Deficiency, Immune Globulin Treatment, and Pregnancy – Hematology.org

  https://www.hematology.org/education/trainees/fellows/hematopoiesis/2023/iga-deficiency-immune-globulin-treatment-and-pregnancy

  B. The patient has an absolute IgA deficiency. RhIG is contraindicated since it is derived from pooled alloimmunized plasma donors. RBCs should be washed prior to transfusion to remove IgA that may be present in the residual plasma of the RBC unit. […] D. The patient should be tested for anti-IgA antibodies. If anti-IgA is present, then most RhIG preparations are contraindicated, and RBCs should be washed. […] The typical transfusion management strategy for patients with a history of IgA deficiency and anaphylactic reaction is to provide washed blood products or blood products collected from IgA-deficient donors, as this will aid in preventing future anaphylactic reactions. […] Therefore, washing of blood products, issuing only IgA-negative blood, and a restriction on receiving RhIG should be considered.

• #18 Transfusion Selective IgA Deficiency | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/28851

  Individuals with selective IgA deficiency may develop anti-IgA antibodies causing allergic reactions when transfused with blood products containing IgA. […] Patients with selective IgA deficiency are at a significantly higher risk of transfusion reactions compared to the general population, making careful blood product selection crucial to prevent complications. […] Experts recommend screening patients with severe selective IgA deficiency and those who have experienced a reaction to blood products in the past for anti-IgA antibodies. […] Clinicians must implement a plan to safely administer blood products in patients who test positive for antibodies. […] Techniques may include sourcing blood products from IgA-deficient donors, administering washed red blood cells and platelets, administering immunoglobulin low in IgA or subcutaneously, or desensitizing the patient to blood products.

• #19 Transfusion Selective IgA Deficiency | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/28851

  In cases where anaphylaxis occurs, prompt emergency intervention is crucial. […] Clinicians must stop the transfusion immediately and administer epinephrine. […] Methods to prevent anaphylactic reactions in patients with anti-IgA antibodies include exclusively using products from IgA-deficient donors and transfusing washed platelets and red blood cells. […] For patients with anti-IgA antibodies who require immunoglobulin replacement, subcutaneous immunoglobulin is a viable alternative. […] Desensitization is an additional management option.

• #20 Selective IgA deficiency – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/selective-iga-deficiency/symptoms-causes/syc-20362236

  There is no treatment specifically for selective IgA deficiency. Treatments focus on addressing the frequent, repeat or long-lasting conditions that develop with this immune system disorder. […] Healthcare professionals recommend wearing a medical bracelet. A bracelet can show that you have selective IgA deficiency and should receive modified blood or blood products.

• #21 Selective IgA deficiency

  https://dermnetnz.org/topics/selective-iga-deficiency

  There is no cure for selective IgA deficiency and it is currently impossible to treat it with immunoglobulin replacement therapy. Treatment is aimed at specific signs and symptoms such as: […] Antibioticssometimes prophylacticare used for infection control. […] These can be corrected with immunoglobulin replacement therapy. […] These may be treated with systemic corticosteroids and other drugs to reduce inflammation or biologics (including monoclonal antibodies). Hormone replacement therapy may also be used in case of endocrine system involvement.

• #22 IgA Deficiency – AmeriPharma® Specialty Care

  https://ameripharmaspecialty.com/other-health-conditions/iga-deficiency/

  Natural ways to increase IgA levels include: […] Vitamin A has been proven to increase IgA levels. Vitamin A is necessary for the release and transport of IgA across the mucosa, therefore, incorporating vitamin A into the diet can potentially improve IgA levels. […] Another dietary recommendation includes fasting, especially if overweight or obese. Fasting can increase IgA levels. […] Since chronic stress can lead to IgA deficiency, managing stress in such patients is of the utmost importance if they have low IgA levels from chronic stress. […] It is also recommended that smokers quit using cigarettes and tobacco products, as they can lower IgA levels.

• #23 Frontiers | Innate Mechanisms in Selective IgA Deficiency

  https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2021.649112/full

  Currently, no specific treatment for SIgAD exists and novel therapeutic strategies could be developed based on the discussed information. […] The treatments used are limited to the management of associated diseases, because replacement of IgA is not possible. […] Patients with SIgAD displaying recurrent upper respiratory tract infections may benefit from at least a 6-month treatment with prophylactic antibiotics. […] Despite the use of prophylactic antibiotics, some patients with SIgAD continue to have recurrent infections which can be treated with intravenous immunoglobulin replacement therapy although this treatment remains controversial. […] It is likely that SIgAD is based on a defect in the process of IgA class switching and therefore a hypothetical treatment based on retinoic acid (RA) is proposed.

• #24 Frontiers | Innate Mechanisms in Selective IgA Deficiency

  https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2021.649112/full

  RA might even be used in combination with vitamin D, because vitamin D induces Tregs and Tregs might also be involved in the development of SIgAD. […] The microbiota and the intestinal immune system display a high level of tolerance which is mediated by high numbers of Treg that are also implicated in the induction and maintenance of intestinal IgA B cell responses. […] Induction of increased numbers and functioning of Tregs might potentially provide a treatment option for SIgAD. […] TNFRSF13 appears to be a good candidate gene in the development of SIgAD and inducing the expression of TACI via demethylation of the relevant DNA sites could provide a rational target for novel therapeutics.

• #25

  https://link.springer.com/article/10.1007/BF02919068

  Thymic hormones have been shown to modulate immunoglobulin production in a number of experiments and it is generally agreed that this action is mediated by modulation of helper and/or suppressor T cell activities. The possibility of upregulating the immunoglobulins is of particular relevance in patients with hypogammaglobulinemias and this paper reports on the results of thymopentin treatment in 9 patients with selective IgA deficiency. […] Taken together, the data suggest that the tested dose regimen of thymopentin (i.e. daily i.m. injections of 1 mg/kg for 2 weeks, then same dose 3 time weekly for 10 weeks) may only work in a subset of patients with selective IgA deficiency.

• #26

  https://turkjpediatr.org/article/view/1178

  Intravenous immunoglobulin therapy is standard for Kawasaki disease (KD) treatment; however, anaphylactic reactions to immunoglobulins are a risk in KD patients with selective IgA deficiency (sIgAD). […] The therapy for KD associated with sIgAD has not been established. […] We report the case of a 5-year-old boy with KD and sIgAD treated with intravenous cyclosporine A (CsA, 3.0 mg/kg/day) instead of intravenous immunoglobulin (IVIG). […] This case report aids in clarifying the role of IgA antibodies in KD and provides evidence that CsA is a potential candidate for first-line therapy for patients with KD with contraindications to IVIG.

• #27

  https://www.aaaai.org/allergist-resources/ask-the-expert/answers/2021/defic

  IgA deficiency is often not associated with any clinically significant increase rate of bacterial infections, because the normal levels of IgG and IgM, as noted in this case. […] I was unable to find any reports of increase morbidity when immunosuppressive therapy was used to treat auto-immunity in the setting of IgA deficiency. The standard precautions that would be used to monitor for infections in any patient on TNF-alpha inhibitor therapy should be adequate.

• #28 IgA Deficiency, Immune Globulin Treatment, and Pregnancy – Hematology.org

  https://www.hematology.org/education/trainees/fellows/hematopoiesis/2023/iga-deficiency-immune-globulin-treatment-and-pregnancy

  If D alloimmunization prophylaxis is required, most RhIG is contraindicated for patients with anti-IgA, since traditional formulations of RhIG utilize the cold ethanol fractionation method of production, resulting in the presence of small amounts of IgA (usually less than 15 g per dose) in the product. […] Fortunately, preparations of RhIG developed using ion exchange chromatography isolation, such as Rh0(D) Immune Globulin Intravenous, should be preferentially considered as there is no contraindication for this preparation per the package insert. […] The presence of some IgA would indicate that washed products and an RhIG restriction would not be necessary.

• #29 Selective IgA deficiency | University of Prince Edward Island

  https://cidd.discoveryspace.ca/disorder/selective-iga-deficiency.html

  The various infections, allergies, or autoimmune disorders associated with IgA deficiency are treated as required. Different treatments to stimulate the immune system itself have been tried with varying success. […] Staphylococcal phage lysate and Propionibacterium acnes vaccine are 2 immunomodulating agents which have been shown to enhance antibody production, and assist in the treatment of recurrent staphylococcal pyodermas in dogs.

• #30 Immunoglobulin A (IgA) Deficiency in Dogs

  https://www.embracepetinsurance.com/health/selective-immunoglobulin-a-deficiency

  The treatment for this disease is typically undertaken only by way of handling infections secondary to it. […] Sometimes, Staphylococcal phage lysate and Propionibacterium acne vaccines are used to enhance IgA antibody production. At the very least, this therapy might assist in the treatment of recurrent or chronic skin infections.

• #31 Selective IgA Deficiency in Dogs – Symptoms, Causes, Diagnosis, Treatment, Recovery, Management, Cost

  https://wagwalking.com/condition/selective-iga-deficiency

  Treatment of Selective IgA Deficiency in Dogs Treatment will depend upon the allergies, reactions, autoimmune disorders, and infections to which the dog is most prone. If the veterinarian feels the dog is well enough and comfortable, he or she will work with you to develop a maintenance plan to include food, exercise, sleeping environment, and ongoing care. Dogs with IgA deficiency will need consistent medical care to manage symptoms and remain comfortable. The owner must be vigilant and keep an eye on any new or recurring symptoms. Many vets recommend supplements that will help stimulate the production of immunoglobulins. […] Many times, antibiotic therapy does not address the infection.

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