Abstract
A fortyseven-year-old female with classical RA was treated with 300mg/day D-penicillamine, therafter her serum IgA gradually decreased. After 2 years treatment, she was often infected with bronchitis. Her serum IgA was 0.5 mg/dl measured by laser nephelometer. Other immunoglebulins were not decreased. Delayed skin reactions were positive and PHA-P and ConA lymphocyte transformation tests revealed normal stimulation indices. E rosette was 66%. Surface IgA bearing cell was 4%. Secretory IgA in saliva was negative. Anti-IgA antibody and anti-milk antibody were negative. Her serum IgA is gradually being elevated after discontinuation of the D-penicillamine. Studies of cytoplasmic immunoglobulin positive cells by a T-B cell co-culture system suggest that the D-penicillamine induced selective IgA deficiency was due to T cell dysfunction.
