Fluctuating levels of serum IgA in individuals with selective IgA deficiency

Monitoring of donors with selective IgA deficiency, i.e., with less than 0.5 mg IgA/l, led to the observation that serum IgA levels wer not constant. Small but significant fluctuations in IgA levels were noted (coefficient of variance: 143%) which were greater than the variability inherent in the testing methodology (coefficient of variance: 10%). These fluctuations created difficulties in terms of defining IgA-deficient blood products and had implications with respect to the mechanisms involved in IgA deficiency. With respect to supplying IgA-deficient blood products, in our experience a cutoff level of 0.5 mg/l should be the maximum permissible IgA concentration in order to ensure that no adverse reactions occur in individuals with class-specific anti-IgA.