[Prevalence and characteristics of selective IgA deficiency in celiac patients]

INTRODUCTION

Celiac disease is a multisystemic autoimmune disease that mainly affects the small intestine. Selective Immunoglobulin A deficiency is the most common primary immunodeficiency in the general population, with an incidence of 1%. It is estimated that it affects 2%-3% of celiac disease and 6.5% of patients with this deficit have celiac disease, observing the important association between both.

OBJECTIVES

To determine the prevalence of selective Immunoglobulin A deficiency in celiac patients. Describe the clinical, serological, and histological presentation and its association with autoimmune diseases.

MATERIALS AND METHODS

Cross-sectional, descriptive, and retrospective study in celiac patients with Immunoglobulin A dosing in the period from March 2005 to March 2020, at the Gastroenterology Clinic, Hospital de Clínicas, Montevideo-Uruguay.

RESULTS

343 patients were included. Seven patients presented selective Immunoglobulin A deficiency (2%). All were female with a mean age of 20 years (4-36). Selective total immunoglobulin A deficiency was observed in 6 patients (85%) and only 1 (15%) had partial deficiency. Tissue transglutaminase antibody immunoglobulin A and antiendomysium antibody were negative in patients with selective total immunoglobulin A deficiency and positive in those with partial deficiency. All presented villous atrophy, gastrointestinal symptoms, and a lower incidence of autoimmune diseases compared to the reference literature.

CONCLUSIONS

The prevalence of selective immunoglobulin A deficiency in this celiac population (2%) is similar to that reported in other populations, reaffirming the importance of including immunoglobulin A dosing for the diagnosis of CD.

[Celiac disease associated with systemic sclerosis]

Systemic scleroderma (SS) affects the connective tissue, with involvement of multiple organs. Digestive system involvement occurs in 50% of patients. SS is frequently associated with other autoimmune diseases. Celiac disease (CD) is an autoimmune disorder that affects the digestive system and is trigged by gluten intake. These two diseases share some HLA antigens. We describe the case of a woman with a diagnosis of SS who presented with weight loss. CD was diagnosed. Because the literature on this topic is scarce, this case is compared with a prior review and some similarities were found. Diagnosis of CD in patients with SS may be difficult but is essential to achieve optimal treatment response in patients with poor quality of life.