目的:确定哮喘病史与选择性IgA缺乏症(sIgAD)/普通可变免疫缺陷(CVID)诊断之间的关系。
方法:这项基于人群的病例对照研究包括奥姆斯特德县的居民,明尼苏达,在1964年1月1日至2008年12月31日期间符合泛美免疫缺陷组织/欧洲免疫缺陷学会的sIgAD/CVID诊断标准。每个病例有4个年龄和性别匹配的对照(2个来自社区,2个来自经历过免疫检查的个人列表)。我们通过应用预定的哮喘标准来确定哮喘状态。
结果:我们确定了39例:26例(66.7%)患有sIgAD,13例(33.3%)患有CVID。在39个案例中,51.3%为男性(n=20),97.1%为白人(34例患者中的33例)。sIgAD/CVID在指数日期(符合标准的时间)的平均年龄为34.2岁。在39个案例中,9(23.1%)在sIgAD/CVID指数日期之前有哮喘病史;在156名对照中,16人(10.3%)在指数日期之前有哮喘病史(比值比,2.77;95%CI,1.09-7.06;P=0.03)。哮喘病史(在sIgAD/CVID的索引日期之前或之后)在sIgAD/CVID病例中(30.8%;n=12)比在匹配的对照组(11.5%;n=18)更为普遍(优势比,3.57;95%CI,1.50-8.51;P=0.01)。
结论:哮喘患者比非哮喘患者更有可能诊断为sIgAD/CVID。这种关联可能是某些哮喘患者细菌感染风险增加的原因。
OBJECTIVE: To determine the association between a history of asthma and a diagnosis of selective IgA deficiency (sIgAD)/common variable immunodeficiency (CVID).
METHODS: This population-based
case-control study included residents of Olmsted County, Minnesota, who met the Pan-American Group for Immunodeficiency/European Society for Immunodeficiencies diagnostic criteria for sIgAD/CVID between January 1, 1964, through December 31, 2008. Each
case had 4 age- and sex-matched controls (2 from the community and 2 from a list of individuals who had undergone an immune work-up). We ascertained asthma status by applying predetermined criteria for asthma.
RESULTS: We identified 39 cases: 26 (66.7%) had sIgAD and 13 (33.3%) had CVID. Of the 39 cases, 51.3% were men (n=20) and 97.1% were white (33 of 34 patients). The mean age at the index date (the time when criteria were met) of sIgAD/CVID was 34.2 years. Of the 39 cases, 9 (23.1%) had a history of asthma before the index date of sIgAD/CVID; of the 156 controls, 16 (10.3%) had a history of asthma before the index date (odds ratio, 2.77; 95% CI, 1.09-7.06; P=.03). A history of asthma (before or after the index date of sIgAD/CVID) was more prevalent in sIgAD/CVID cases (30.8%; n=12) than in matched controls (11.5%; n=18) (odds ratio, 3.57; 95% CI, 1.50-8.51; P=.01).
CONCLUSIONS: Asthmatic patients are more likely to have a diagnosis of sIgAD/CVID than nonasthmatic individuals. This association may potentially account for the increased risks of bacterial infections in some individuals with asthma.