title: Helicobacter pylori infection in patients with selective immunoglobulin a deficiency.
abstract: Selective immunoglobulin A (IgA) deficiency (IgAD) is the most common primary immunodeficiency in the western world. The aim of the study was to investigate the prevalence and clinical characteristics of Helicobacter pylori-infected dyspeptic patients with IgAD. Case samples were drawn from all subjects ≥ 12 years of age (n = 104729) who had undergone serum total IgA measurements during 2004-14 for any reason at Leumit Healthcare Services (Israel) and had serum total IgA < 0·07 g/l. The control group was comprised of a random sample of remaining patients with a case-control ratio of 10 controls for each case. The dyspeptic diseases were identified and retrieved from Leumit Health Care Services electronic database using specific ICD-9-CM diagnostic codes. The case group included 347 subjects and the control group 3470 subjects. There were no significant differences in the prevalence of patients with dyspepsia [84 (24·2%) versus 821 (23·6%) for cases and controls, respectively]. Additionally, there was no difference in a proportion of dyspeptic H. pylori-positive subjects [59 (17·1%) versus 524 (15·1%)] between the case and control groups. Only 59 (17%) among the 347 IgAD patients underwent gastroscopy. A significantly larger proportion of case subjects experienced several forms of gastritis [13 (61·9%) versus 38 (21·6%), P < 0·001), duodenal ulcers [seven (33·3%) versus 19 (10·8%); P = 0·01] and nodular lymphoid hyperplasia (NLH) [two (9·5%) versus none; P = 0·011]. IgAD is not associated with increased prevalence of H. pylori-associated dyspepsia; nevertheless, H. pylori-infected dyspeptic IgAD subjects experience more EGD-proved gastritis, duodenal ulcers and NLH.
authors.affiliation: Leumit Health Services, Ashdod, Israel.|Clinical Immunology and Allergy Unit, Barzilai University Medical Center, Ben Gurion University of the Negev, Ashkelon, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Magen
authors.affiliation: Leumit Health Services, Ashdod, Israel.
authors.forename: D-A
authors.initials: DA
authors.lastname: Waitman
authors.affiliation: Clinical Immunology and Allergy Unit, Barzilai University Medical Center, Ben Gurion University of the Negev, Ashkelon, Israel.
authors.forename: N
authors.initials: N
authors.lastname: Goldstein
authors.affiliation: Clinical Immunology and Allergy Unit, Barzilai University Medical Center, Ben Gurion University of the Negev, Ashkelon, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Schlesinger
authors.affiliation: Leumit Health Services, Ashdod, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Dickstein
authors.affiliation: Leumit Health Services, Ashdod, Israel.|School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: N R
authors.initials: NR
authors.lastname: Kahan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005871:Castleman Disease / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D002648:Child; D016208:Databases, Factual; D004381:Duodenal Ulcer / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D004415:Dyspepsia / Q000175:diagnosis* / Q000276:immunology; D057286:Electronic Health Records; D005756:Gastritis / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D016480:Helicobacter pylori / Q000254:growth & development / Q000276:immunology; D006801:Humans; D017098:IgA Deficiency / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D007070:Immunoglobulin A / Q000097:blood; D007557:Israel; D008875:Middle Aged
chemical_list: D007070:Immunoglobulin A
keywords: Helicobacter pylori; IgA; deficiency; immunoglobulin; selective