Selective IgA Deficiency in Children With Recurrent Parotitis of Childhood

Abstract

Recurrent parotitis of childhood is defined as the relapsing form of juvenile (idiopathic) parotitis and represents a rare inflammatory disorder of the parotid gland with potentially significant morbidity. We reviewed the charts of patients who were diagnosed with inflammatory parotid diseases in our institution between 1992 and 2002. There were 91 patients presenting with juvenile parotitis (1 of 6117 of all clinical visits). Of these 91 cases, 23 patients (28%) had the relapsing form of juvenile parotitis, and the median number of episodes was 5 (range, 2-20). Laboratory investigations revealed that 5 patients had selective IgA deficiency. The prevalence (22%) is different from the cumulative prevalence of IgA deficiency in a healthy population (0.3%; P < 0.001).

A Boy With Sjogren’s Syndrome and Recurrent Parotitis Who Presented With Suspicious of Allergic and Immunological Disease: Review of the Literature

“…IgA is the primary immunoglobulin secreted into mucosal surfaces and saliva, including respiratory and gastrointestinal tracts. The finding of higher prevalence of IgA deficiency among children with RP suggests that lack of IgA in the parotid glands may be associated with inability of complete clearance of inflammatory stimuli in the glands [7,8]. In our case, no allergic or immunological disorder was detected; rather, a mild hypergammaglobulinemia was observed.…”

“…Association of RP with allergic and immunological diseases has been rarely reported [1]. Associations of recurrent parotid with immune deficiencies such as isolated immunoglobulin G 3 (IgG 3 ) deficiency, immunoglobulin A (IgA) deficiency, hypogammaglobulinemia, immunoglobulin M (IgM) deficiency or Xlinked hypogammaglobulinemia and allergic diseases such as atopic dermatitis, blepharitis or hay fever have also been reported [2][3][4][5][6][7][8] (Table 1). In this manuscript, we reported a 4-year-old boy presented with multiple episodes of painful swelling in both parotid glands over a 2-year period and suspicion of allergic disease.…”

Parotidite recorrente da infância

“…Alguns casos de PRI estão associados às imunodeficiências, como deficiência de IgA e infecção pelo HIV (11,12) . Nas imunodeficiências, os episódios de otite, sinusite, pneumonia e diarréia de repetição são mais comuns do que nos pacientes com PRI (11,12) .…”

“…Nas imunodeficiências, os episódios de otite, sinusite, pneumonia e diarréia de repetição são mais comuns do que nos pacientes com PRI (11,12) . Neste caso, apesar de a criança ter antecedentes de asma e rinite, a família negava infecções de repetição e os exames laboratoriais estavam normais, afastando as hipóteses de deficiência de IgA e infecção pelo HIV (11,12) .…”

Current Management of Juvenile Recurrent Parotitis

“…As pus is only very rarely found, the administration of antibiotics in the absence of a bacterial infection is disputed [8 •• ]. Congenital changes in the duct system [9, 10, 11 •• , 12, 13], autoimmune disease [9,14], autosomal dominant inheritance [15], immune deficiency [3,16,17], and disrupted enzyme activity [18] have all been discussed. In 2004, Nahlieli proposed a further hypothesis based on the endoscopic picture of the ducts during sialendoscopy.…”