BACKGROUND: Selective immunoglobulin A (IgA) deficiency (SIgAD) is associated with coeliac disease (CD). AIM: To make a retrospective study of the association of SIgAD with CD in Italy. METHODS: Hospital medical records of 2098 patients consecutively diagnosed as having CD were reviewed. RESULTS: Of 2098 patients with CD, 54 (2.6%) had SIgAD, representing a 10-16-fold increase over that in the population in general. This increase was not influenced by age or geographical factors. Patients with SIgAD had a higher incidence of silent forms (7/54, 13%), recurrent infections (16/54, 29.6%), and atopic diseases (7/54, 13%) than those without. The association with autoimmune and malignant diseases and the outcome after eating a gluten free diet were similar in patients with or without SIgAD. In all patients with SIgAD, antibodies for IgA gliadin and endomysium were absent, but serum levels of IgG anti-gliadin antibodies were high in almost all of them (51/54). CONCLUSIONS: Serum IgA should be measured in order to be able to interpret negative results for IgA anti-gliadin antibodies and anti-endomysial antibodies in patients being screened for CD. Since some patients with CD and SIgAD may be negative for IgG anti-gliadin antibodies, an intestinal biopsy should be performed in all suspected cases.
BACKGROUND: Selective immunoglobulin A (IgA) deficiency (SIgAD) is associated with coeliac disease (CD). AIM: To make a retrospective study of the association of SIgAD with CD in Italy. METHODS: Hospital medical records of 2098 patients consecutively diagnosed as having CD were reviewed. RESULTS: Of 2098 patients with CD, 54 (2.6%) had SIgAD, representing a 10-16-fold increase over that in the population in general. This increase was not influenced by age or geographical factors. Patients with SIgAD had a higher incidence of silent forms (7/54, 13%), recurrent infections (16/54, 29.6%), and atopic diseases (7/54, 13%) than those without. The association with autoimmune and malignant diseases and the outcome after eating a gluten free diet were similar in patients with or without SIgAD. In all patients with SIgAD, antibodies for IgA gliadin and endomysium were absent, but serum levels of IgG anti-gliadin antibodies were high in almost all of them (51/54). CONCLUSIONS: Serum IgA should be measured in order to be able to interpret negative results for IgA anti-gliadin antibodies and anti-endomysial antibodies in patients being screened for CD. Since some patients with CD and SIgAD may be negative for IgG anti-gliadin antibodies, an intestinal biopsy should be performed in all suspected cases.
Authors: P D Thomas; A Forbes; J Green; P Howdle; R Long; R Playford; M Sheridan; R Stevens; R Valori; J Walters; G M Addison; P Hill; G Brydon Journal: Gut Date: 2003-07 Impact factor: 23.059
Authors: L Greco; A Veneziano; L Di Donato; C Zampella; M Pecoraro; D Paladini; F Paparo; A Vollaro; P Martinelli Journal: Gut Date: 2004-01 Impact factor: 23.059
Authors: L Högberg; P Laurin; K Fälth-Magnusson; C Grant; E Grodzinsky; G Jansson; H Ascher; L Browaldh; J-A Hammersjö; E Lindberg; U Myrdal; L Stenhammar Journal: Gut Date: 2004-05 Impact factor: 23.059