title: Selective IgA deficiency mimicking Churg-Strauss syndrome and hypereosinophilic syndrome: a case report.
abstract: Selective IgA deficiency (SIgAD) is the most common type of primary immunoglobulin deficiency. Most individuals with SIgAD are asymptomatic. However, some patients are associated with allergic and autoimmune disease. SIgAD is included in the list of differential diagnoses of eosinophilia. We experienced a patient who initially presented with abdominal pain and eosinophilia. A >1-year follow-up revealed SIgAD, and we had difficulty differentiating it from Churg-Strauss syndrome (CSS) or hypereosinophilic syndrome (HES). A 66-year-old Japanese male presented with a history of recurrent abdominal pain. A diagnostic work-up revealed eosinophilia, eosinophilic gastritis, eosinophilic pneumonia, and SIgAD over 1 year of clinical observation. He also suffered from asthma and sinusitis. Anti-neutrophil cytoplasmic antibody was negative and vasculitis was not detected in the obtained tissue specimens of stomach, lung, nose and skin. The patient showed no evidence of drug ingestion, parasitic infections, or malignant neoplasms. Although we cannot rule out prevasculitic CSS and idiopathic HES, the whole clinical picture in this patient can be explained most consistently by SIgAD.
authors.affiliation: Department of General Medicine/Family & Community Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan. nori1007@med.nagoya-u.ac.jp
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Takahashi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kondo
authors.forename: Mamiko
authors.initials: M
authors.lastname: Fukuta
authors.forename: Ayumu
authors.initials: A
authors.lastname: Takemoto
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Takami
authors.forename: Motoki
authors.initials: M
authors.lastname: Sato
authors.forename: Takafumi
authors.initials: T
authors.lastname: Ando
authors.forename: Naozumi
authors.initials: N
authors.lastname: Hashimoto
authors.forename: Tomio
authors.initials: T
authors.lastname: Suzuki
authors.forename: Juichi
authors.initials: J
authors.lastname: Sato
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamamura
authors.forename: Nobutaro
authors.initials: N
authors.lastname: Ban
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000368:Aged; D001706:Biopsy; D015267:Churg-Strauss Syndrome / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004751:Enteritis / Q000209:etiology; D004802:Eosinophilia / Q000209:etiology; D005756:Gastritis / Q000209:etiology; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000175:diagnosis*; D017098:IgA Deficiency / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D011237:Predictive Value of Tests; D011657:Pulmonary Eosinophilia / Q000209:etiology; D012008:Recurrence; D013997:Time Factors; D014057:Tomography, X-Ray Computed
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