title: Prevalence and clinical features of selective immunoglobulin A deficiency in coeliac disease: an Italian multicentre study. Italian Society of Paediatric Gastroenterology and Hepatology (SIGEP) and "Club del Tenue" Working Groups on Coeliac Disease.
abstract: BACKGROUND
  Selective immunoglobulin A (IgA) deficiency (SIgAD) is associated with coeliac disease (CD).
  
  
  OBJECTIVE
  To make a retrospective study of the association of SIgAD with CD in Italy.
  
  
  METHODS
  Hospital medical records of 2098 patients consecutively diagnosed as having CD were reviewed.
  
  
  RESULTS
  Of 2098 patients with CD, 54 (2.6%) had SIgAD, representing a 10-16-fold increase over that in the population in general. This increase was not influenced by age or geographical factors. Patients with SIgAD had a higher incidence of silent forms (7/54, 13%), recurrent infections (16/54, 29.6%), and atopic diseases (7/54, 13%) than those without. The association with autoimmune and malignant diseases and the outcome after eating a gluten free diet were similar in patients with or without SIgAD. In all patients with SIgAD, antibodies for IgA gliadin and endomysium were absent, but serum levels of IgG anti-gliadin antibodies were high in almost all of them (51/54).
  
  
  CONCLUSIONS
  Serum IgA should be measured in order to be able to interpret negative results for IgA anti-gliadin antibodies and anti-endomysial antibodies in patients being screened for CD. Since some patients with CD and SIgAD may be negative for IgG anti-gliadin antibodies, an intestinal biopsy should be performed in all suspected cases.
authors.affiliation: Clinica Pediatrica R, Palermo, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Cataldo
authors.forename: V
authors.initials: V
authors.lastname: Marino
authors.forename: A
authors.initials: A
authors.lastname: Ventura
authors.forename: G
authors.initials: G
authors.lastname: Bottaro
authors.forename: G R
authors.initials: GR
authors.lastname: Corazza
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002446:Celiac Disease / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006683:HLA-DQ Antigens / Q000032:analysis; D015803:HLA-DR3 Antigen / Q000032:analysis; D006801:Humans; D017098:IgA Deficiency / Q000209:etiology*; D007223:Infant; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D006683:HLA-DQ Antigens; C053186:HLA-DQ2 antigen; D015803:HLA-DR3 Antigen