Chronic mucocutaneous candidiasis may cause elevated gliadin antibodies.
We present a 4-year-old boy admitted to the hospital due to the typical symptoms of celiac disease with severe dystrophy, anaemia and elevated gliadin IgG antibodies. Upper endoscopy ruled out celiac disease but showed severe Candida esophagitis. Due to an impaired T-cell function especially following Candida antigen stimulation in vitro, plus recurrent Candida infections of the skin, the diagnosis of chronic mucocutaneous candidasis (CMC) was made. Under the treatment with fluconazol, trimethoprim/sulfmethoxazole and IVIG, the child improved impressively. Gliadin antibodies declined steadily.


CONCLUSIONS
The common symptoms growth retardation, anaemia and elevated gliadin antibodies are suggestive for celiac disease but very unspecific. The rare immunodeficiency CMC may cause elevated gliadin antibodies.
Brinkert
Florian
F
Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Immunology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. f.brinkert@uke.uni-hamburg.de
Sornsakrin
Marijke
M
Krebs-Schmitt
Dorothee
D
Ganschow
Rainer
R
D000935:Antifungal Agents / Q000627:therapeutic use; D002178:Candidiasis, Chronic Mucocutaneous / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D002446:Celiac Disease / Q000175:diagnosis; D002675:Child, Preschool; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D004941:Esophagitis / Q000382:microbiology; D005903:Gliadin / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007153:Immunologic Deficiency Syndromes / Q000175:diagnosis*; D008297:Male; D016176:T-Lymphocyte Subsets / Q000276:immunology
D000935:Antifungal Agents; D007074:Immunoglobulin G; D005903:Gliadin