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©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 14, 2014; 20(46): 17686-17689
Published online Dec 14, 2014. doi: 10.3748/wjg.v20.i46.17686
Published online Dec 14, 2014. doi: 10.3748/wjg.v20.i46.17686
Reversal of IgM deficiency following a gluten-free diet in seronegative celiac disease
Lucia Montenegro, Domenico Piscitelli, Floriana Giorgio, Claudia Covelli, Maria Grazia Fiore, Giuseppe Losurdo, Andrea Iannone, Enzo Ierardi, Alfredo Di Leo, Mariabeatrice Principi, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy
Alfredo Di Leo, Gastroenterology Unit, Policlinico Hospital, 70124 Bari, Italy
Author contributions: Montenegro L and Iannone A followed the patient; Piscitelli D, Covelli C and Fiore MG performed histology and immunohistochemistry; Principi M performed endoscopy, Giorgio F and Losurdo G performed molecular investigation; Ierardi E and Di Leo A collected the data and wrote the paper; all approved the final version.
Correspondence to: Alfredo Di Leo, Professor, Gastroenterology Unit, Policlinico Hospital, Piazza G Cesare 11, 70124 Bari, Italy. alfredo.dileo@uniba.it
Telephone: +39-80-5592577 Fax: + 39-80-5593088
Received: April 23, 2014
Revised: June 17, 2014
Accepted: August 13, 2014
Published online: December 14, 2014
Processing time: 238 Days and 21.3 Hours
Revised: June 17, 2014
Accepted: August 13, 2014
Published online: December 14, 2014
Processing time: 238 Days and 21.3 Hours
Core Tip
Core tip: Selective IgM deficiency is a rare condition, associated in 5% of cases to Celiac Disease (CD). The CD diagnosis in patients with immunoglobulin deficiencies is based only on response to a Gluten-Free Diet (GFD). Deposits of tissue transglutaminase are found in duodenal samples of seronegative CD. Our case (IgM deficiency/seronegative CD) disclosed novel insights: (1) it is possible to observe a selective association of IgM deficiency/seronegative CD; (2) the histological diagnosis of CD may be complex due to poor lymphocyte maturation; (3) mRNA coding for tissue transglutaminase in duodenal mucosa could be a useful diagnostic tool; and (4) GFD may reverse IgM deficiency by promoting lymphocyte maturation.