Profound Reversible Hypogammaglobulinemia Caused by Celiac Disease in the Absence of Protein Losing Enteropathy

Journal of Clinical Immunology
Rohan AmeratungaWikke Koopmans

Abstract

When patients with hypogammaglobulinemia are encountered, a vigorous search should be undertaken for secondary treatable causes. Here we describe the first case of a patient with severe asymptomatic hypogammaglobulinemia where the underlying cause was undiagnosed celiac disease. A strict gluten free diet resulted in resolution of her mild long-standing abdominal symptoms and correction of her hypogammaglobulinemia. There was corresponding improvement in her duodenal histology and normalisation of her celiac serology. Protein losing enteropathy was unlikely to have been the mechanism of her profound hypogammaglobulinemia, as her albumin was within the normal range and she had a normal fecal alpha 1 antitrypsin level. Application of the Ameratunga et al. (2013) diagnostic criteria was helpful in confirming this patient did not have Common Variable Immunodeficiency Disorder (CVID). Celiac disease must now be considered in the differential diagnosis of severe hypogammaglobulinemia. There should be a low threshold for undertaking celiac serology in patients with hypogammaglobulinemia, even if they have minimal symptoms attributable to gut disease.

References

Feb 1, 1981·Gut·A D WebsterG L Asherson
Dec 1, 1995·Australian and New Zealand Journal of Medicine·J RavindranR Heddle
Jul 22, 1999·Clinical Immunology : the Official Journal of the Clinical Immunology Society·C Cunningham-Rundles, C Bodian
Jan 16, 2003·The American Journal of Gastroenterology·Giuseppe LuziFernando Aiuti
Sep 3, 2004·Current Gastroenterology Reports·Ishaan Kalha, Joseph H Sellin
Jan 25, 2006·Autoimmunity Reviews·Adina Kay Knight, Charlotte Cunningham-Rundles
Aug 25, 2006·Journal of Gastroenterology and Hepatology·Ajit SoodAlok Sehgal
Mar 17, 2007·Scandinavian Journal of Infectious Diseases·Ann-Margreth Olinder-NielsenJanne Björkander
Mar 30, 2007·Nature Genetics·Qiang Pan-HammarströmLennart Hammarström
Apr 14, 2007·Digestive Diseases and Sciences·Ahmad KhodadadNasser Ebrahimi Daryani
Oct 4, 2007·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Shradha Agarwal, Charlotte Cunningham-Rundles
Apr 19, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Eric OksenhendlerUNKNOWN DEFI Study Group
Jul 31, 2008·Journal of Pediatric Gastroenterology and Nutrition·M Abu-ZekryA Fasano
Apr 7, 2009·British Journal of Haematology·Helen Chapel, Charlotte Cunningham-Rundles
Jun 17, 2010·The American Journal of Gastroenterology·Georgia MalamutChristophe Cellier
Jun 18, 2010·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Antonio CarroccioNorberto Pogna
Dec 7, 2010·Postgraduate Medical Journal·Richard Steele, UNKNOWN CRF
Jan 31, 2013·Scandinavian Journal of Immunology·W KoopmansR Ameratunga
Feb 14, 2013·Journal of Pediatric Gastroenterology and Nutrition·Benjamin C HopeSimon E Chin
Feb 20, 2013·Journal of Clinical Immunology·Ivan J FussWarren Strober
Apr 24, 2013·Journal of Clinical Immunology·Nils VenhoffJens Thiel
Apr 24, 2013·The American Journal of Gastroenterology·Alberto Rubio-TapiaUNKNOWN American College of Gastroenterology
Dec 18, 2013·Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology·Rohan AmeratungaChris Kenedi
Jan 15, 2014·Expert Review of Clinical Immunology·Rohan AmeratungaRichard Steele
Oct 14, 2014·Frontiers in Immunology·Rohan AmeratungaSee-Tarn Woon

❮ Previous
Next ❯

Citations

Dec 2, 2015·Expert Review of Clinical Immunology·Rohan AmeratungaSee-Tarn Woon
Oct 17, 2017·Clinical Reviews in Allergy & Immunology·Rohan AmeratungaRichard Steele
Nov 14, 2019·Clinical Reviews in Allergy & Immunology·Rohan Ameratunga, See-Tarn Woon
Jul 9, 2021·Clinical Reviews in Allergy & Immunology·Rohan AmeratungaSee-Tarn Woon
Mar 30, 2017·Clinical Immunology : the Official Journal of the Clinical Immunology Society·Vincenzo GrazianoGiuseppe Spadaro

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Boletín médico del Hospital Infantil de México
P Coello-RamírezJ Trujillo
Annali italiani di medicina interna : organo ufficiale della Società italiana di medicina interna
R CaprilliE Tomei
© 2021 Meta ULC. All rights reserved