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Case Reports
 

Selective Immunoglobulin A Deficiency and Celiac Disease: Let’s Give Serology a Chance
 

E Valletta,1,2 M Fornaro,1,2 S Pecori,3 G Zanoni4

1Department of Pediatrics, University of Verona, Verona, Italy
2Department of Pediatrics, AUSL Forlì, Italy
3Institute of Pathologic Anatomy, University of Verona, Verona, Italy
4Institute of Clinical Immunology, University of Verona, Verona, Italy

J Investig Allergol Clin Immunol 2011; Vol. 21(3): 242-244
 

 Abstract


Patients with selective immunoglobulin (Ig) A deficiency have a 10- to 20-fold increased risk of celiac disease. In these patients, serological diagnosis of celiac disease can be difficult, since specific IgA-based assays are usually negative and IgG-specific antibody tests are insufficiently reliable. We describe a girl with selective IgA deficiency who had a troublesome diagnosis of celiac disease that was established only after an unexpected positive test result for antitransglutaminase IgA and antiendomysium IgA. Our observation indicates that IgA-based serology should not be forgotten in patients with selective IgA defi ciency, since positive results for antitransglutaminase IgA, antiendomysium IgA, or both can be observed at any time during diagnostic investigations.

Key words: Celiac disease. Immunoglobulin A deficiency. Diagnosis. Transglutaminase antibodies. Endomysial antibodies.