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Celiac disease associated with familial chronic urticaria and thyroid autoimmunity in a child
A Levine1, I Dalal, Y Bujanover
1Pediatric Gastroenterology Unit, E Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Insights
Chronic urticaria (CU) in a child with celiac disease persisted despite a gluten-free diet. This suggests CU may be linked to the autoimmune aspects of celiac disease, even in pediatric cases.
Area of Science:
- Pediatric autoimmune disorders
- Gastroenterology
- Immunodermatology
Background:
- Celiac disease is an autoimmune disorder triggered by gluten ingestion.
- Chronic urticaria (CU) is a complex inflammatory skin condition.
- Autoimmune conditions often present with overlapping symptoms and genetic predispositions.
Observation:
- An 11-year-old girl with diagnosed celiac disease presented with chronic urticaria (CU) and antithyroid antibodies.
- Family history revealed a multi-generational pattern of CU and thyroid autoimmunity.
- Human leukocyte antigen (HLA) typing identified shared HLA-DQA1*0501-DQB1*0201 alleles in mother and child.
Findings:
- Despite clinical and laboratory resolution of celiac disease, CU remained unresponsive to a gluten-free diet in this pediatric patient.
- This contrasts with some adult cases where dietary changes resolve associated urticaria.
- The persistence of CU suggests it may be an independent autoimmune manifestation linked to celiac disease.
Implications:
- This case highlights that chronic urticaria could be part of the broader autoimmune spectrum associated with celiac disease in children.
- Pediatricians and gastroenterologists should consider evaluating for autoimmune comorbidities in children with celiac disease and persistent CU.
- Further research is warranted to understand the immunopathogenesis of CU in the context of celiac disease and its genetic underpinnings.
Abstract:
An 11-year-old girl presented with chronic urticaria (CU), antithyroid antibodies, and anemia. Celiac disease was diagnosed. The family history was positive for maternally derived CU and thyroid autoimmunity in three generations. Human leukocyte antigen typing disclosed human leukocyte antigen DQA1*0501 DQB1*0201 in both mother and child. CU was unresponsive to a gluten-free diet despite clinical and laboratory resolution of celiac disease in contrast to previous reports in adults. We believe that this is the first report of this association in a child, highlighting that CU may be a part of the spectrum of autoimmune phenomenon related to celiac disease.