Introduction: Selective IgA deficiency occurs in one of 39 to 57 patients with celiac disease (CD). This is much higher than the prevalence of selective IgA deficiency (IgA-D) in the general population, which is about 1 in 400 to 18 500, depending on ethnic background.
Case report: A 20 year-old female patient, presented in our institution for etiological assessment, of an ongoing watery chronic diarrhea. Associated to intermittent minimal intensity abdominal pain. Our patient also reported a significant weight loss, with conserved appetite. Laboratory tests showed an iron deficiency anemia, blood ionogram and hepatic balance were normal. Etiological biology tests revealed negative Inflammatory markers. Normal endocrine tests Celiac disease serology revealed: negative IgA TG:2560 CU. IgA serum levels were low <0.02.
Discussion: The ID universe is an impressive field in immunology because of the variability of clinical and autoimmune characteristics. Gastrointestinal involvement is common and sometimes resembles primary digestive disorders like CD. Additionally, the shortage of immunoglobulin production often accounts for the absence of serological markers of CD. For this reason, ID could mask CD, and the diagnostic of the frequent association between Celiac disease and ID could be a challenge. Selective IgA deficiency is that the foremost typical primary ID, with a prevalence of 1/300–700 individuals.. sIgAD becomes clinically evident in childhood, due to recurrent respiratory and gastrointestinal infections. False negative serology without classical digestive symptoms in the pulpart of CD patients within the SIgAD makes CD more difficult to detect. Factors determining CD involvement with SIgAD can be seropositive or seronegative is unclear. PIgAD is a common phenomenon both in people watched for gastrointestinal disorders and in the healthy population and has not occupied the diagnostic performance of IgA-tTG serology within the detection of CD.
Conclusion: IgA deficiency creates challenges within the management of patients undergoing evaluation for CD. We suggest that IgA deficiency and CD occur more commonly when employing a case-finding strategy to test for CD compared with testing the general population.
Keywords: Celiac disease, Selective IgA deficiency, Diagnostic trap, IgA-tTG, Intestinal biopsy, Gastroscopy
