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  • IgA autoantibodies in...

IgA autoantibodies in breast milk linked to neonatal LABD in JAMA study

Written By : Dr. Shravani Dali |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-07-22T09:00:51+05:30  |  Updated On 22 July 2021 9:01 AM IST
IgA autoantibodies in breast milk linked to neonatal LABD in JAMA study
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The pathogenic IgA is passively transferred to a new-born from an asymptomatic mother via breast milk, according to this study published in the JAMA Dermatology journal.

Neonatal linear immunoglobulin A bullous dermatosis (LABD) is a rare but deadly disorder that can cause death in a new-born due to respiratory failure. Until now there was no definite cause for the pathogenic IgA responsible for neonatal LABD in the infants born to healthy asymptomatic mothers.

A single case study was conducted by researchers from Japan on a breast-fed new-born male who was a confirmed case of neonatal linear immunoglobulin A bullous dermatosis (LABD) at Keio University Hospital in Tokyo. They conducted this study to pinpoint the exact cause of the presence of pathogenic IgA associated with LABD in neonates born of healthy asymptomatic mothers. The selected newborn had developed deadly blisters and erosions of the skin and mucous membranes on day 4 after birth.

The researchers evaluated his following laboratory findings: Blood serum, skin, and maternal breast milk were examined for IgA autoantibodies. Histopathologic and immunofluorescence analyses of serum, skin, and breast milk from the patient and his mother were carried out.

The researchers found that:

· Histopathologic evaluation of the patient's skin showed subepidermal blisters with neutrophil infiltrates.

· While the diagnosis of neonatal LABD was due to his immunofluorescence testing that revealed linear IgA deposition along the basement membrane zone (BMZ).

· Indirect immunofluorescence using normal human skin after treatment with 1-mol/L sodium chloride revealed the patient had circulating IgA binding to the dermal side of BMZ.

· The presence of the J chain indicated that the autoantibodies producing the blisters were derived from the maternal breast milk.

· There were no circulating IgA against the skin was detected in the mother's sera, but the breast milk contained IgA that reacted with the dermal side of the BMZ.

· No new blister formation was observed after stopping breastfeeding.

The researchers concluded that the origin of pathogenic IgA in the neonates was via passive transfer from asymptomatic mother's breast milk. Also, contrary to previous studies they found IgA autoantibodies in the maternal breast milk, hence they suggested that breast milk feeding should be discontinued as soon as neonatal LABD is suspected.

Reference:

A study titled, "Neonatal Linear IgA Bullous Dermatosis Mediated by Breast Milk–Borne Maternal IgA" by Egami S et. al published in the JAMA Dermatol journal.

doi:10.1001/jamadermatol.2021.2392



breast milkigaasymptomatic mothersneonatal linear immunoglobulin a bullous dermatosisjama dermatol journallabdinfantsneonatesdeadly disorder
Source : JAMA Dermatol journal
Dr. Shravani Dali
Dr. Shravani Dali

    Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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