*5.1. Asymptomatic*

Most of the patients are asymptomatic. The estimate number is 60% [8], but it varies in different studies. These patients might develop some clinical manifestations; therefore, they should undergo regular evaluations [34]. A 22-year study based on a cohort of 184 pediatric SIgAD patients, performed by Lougaris et al. [66] shows how the clinical presentation of the disease can vary with time. They assessed laboratory parameters and long-term health status of patients, 62% of whom had symptoms at the time of diagnosis. Allergic complications during follow-up were additionally developed in 16%, autoimmune diseases excluding celiac disease in 9%, and celiac disease developed in 11% of previously disease-free patients. During the follow-up period, 4% of patients achieved age-appropriate IgA levels, 9% of patients achieved partial IgA deficiency diagnosis and 2% of patients developed CVID.
