Reversal of IgM deficiency following a gluten-free diet in seronegative celiac disease

Figure 1 Duodenal biopsy specimens before (A) and 6 mo after (B) gluten-free diet in our patient with Selective IgM deficiency and seronegative celiac disease. A subtotal villous atrophy with an almost flat mucosa is evident before, and complete villous restoration after the dietary therapy (HE: × 200).

Figure 2 Duodenal biopsy specimens before (A) and 12 mo after (B) gluten-free diet in our patient with Selective IgM deficiency and seronegative celiac disease. Immunohistochemistry showed a mild reduction of CD 79a immature lymphocytes. Positive cells are stained brown and counterstained blue (× 200).

Figure 3 Duodenal biopsy specimens before (A) and 12 mo after (B) gluten-free diet in our patient with Selective IgM deficiency and seronegative celiac disease. Immunohistochemistry showed scarse MUM1 plasma cells before the diet and a marked positivity 12 mo later. Positive cells are stained brown and counterstained blue (× 200).