Selective immunoglobulin A deficiency in a sample of Iraqi blood donors in the National Blood Transfusion Center-Baghdad

BACKGROUND: Selective immunoglobulin (Ig) A deficiency is the most common Ig deficiency in the world. Serum IgA level is reduced, 7 mg/dL (70 μg/mL), thus, associating with a wide range of clinical symptoms and signs that are related directly and indirectly to disturbances in the body immune system. Selective IgA deficiency patients are known to develop antibodies against lacking IgA. Whenever these antibodies are found in an individual's circulating blood, a severe allergic response and anaphylaxis can ensue upon receiving IgA containing blood or blood components. Hence, certain protocols are recommended in populations with increased prevalence of selective IgA deficiency including the use of red blood cell (RBC) washing machines or IgA-deficient blood components. Both measures are costly and require special maintenance procedures. objectives: The aim of this study was to screen for the presence of selective IgA deficiency in a group of blood donors and its probable role in the events of transfusion reactions that frequently occur which may necessitate the application of protocols that involve sophisticated procedures and highly-demanding machines. SUBJECTS AND METHODS: This was a laboratory study that included 300 volunteer blood donors in the National Blood Transfusion Center. They were screened for their serum IgA levels. Related questionnaire was conducted and chemiluminescence immunoassay technique with MAGLUMI 600 series machine was used. This machine is already used by the National Center of Teaching Laboratories for variety of biochemical and immunological assays. Serum IgA levels then were plotted against age, blood group and smoking status. RESULTS: No single case of Selective IgA deficiency was documented. Serum IgA levels showed increased levels with age and smoking demonstrated no significant effect on the Ig levels. CONCLUSION: In light of these results, it does not seem urgent or necessary at this point of time to introduce the highly demanding and expensive RBC washing machines in blood banks in Iraq. We recommend conducting a larger study that is more comprehensive with wider involvement of population, considering age, gender, and ethnicity.