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Recognition of Epidermal Transglutaminase by IgA and Tissue Transglutaminase 2 Antibodies in a Rare Case of Rhesus Dermatitis

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Coeliac disease.

Mahbub Mutanabbi¹, M Khaled Noor, M Al Helal

¹Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka, Bangladesh. mutanabbi@dhaka.net

Mymensingh Medical Journal : MMJ

|April 21, 2009

Summary

This summary is machine-generated.

Coeliac disease, an autoimmune disorder, involves gluten intolerance causing small intestine damage. Early diagnosis and a gluten-free diet are crucial for managing symptoms and improving nutrient absorption.

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Area of Science:

Gastroenterology
Immunology
Genetics

Background:

Coeliac disease is an autoimmune small bowel disorder triggered by gluten in genetically susceptible individuals.
It commonly presents in infancy (6 months-2 years) but can occur at any age.
Gluten exposure leads to an immune response, damaging the small intestine lining and impairing nutrient absorption.

Observation:

A 12-year-old male presented with chronic diarrhea, abdominal distension, bloating, and weight loss.
Clinical examination revealed malnutrition, pallor, and clubbing, with significantly below-average height and weight.
Diagnostic workup included fecal fat, imaging, biopsy, and elevated tissue transglutaminase IgA autoantibodies, even after gluten withdrawal.

Findings:

Histopathology suggested immunoproliferative small intestinal disease.
Elevated tissue transglutaminase IgA autoantibodies persisted despite a gluten-free diet.
Complete gluten withdrawal led to gradual improvement in diarrhea, abdominal distension, and bloating.

Implications:

This case highlights the importance of considering coeliac disease in patients with chronic gastrointestinal symptoms and failure to thrive.
Persistent elevated autoantibodies post-gluten withdrawal warrant further investigation.
Early diagnosis and strict adherence to a gluten-free diet are essential for managing coeliac disease and improving patient outcomes.