[Adult coeliac disease and very high IgA plasma level (author's transl)]

The authors report a case of malabsorption syndrome with jejunal atrophy in a 63 years old woman. Coeliac disease was suspected from clinical and histological features, clinical evolution with diet, and presence of HLA B8 antigen. However, this case was very particular because the infiltration of lamina propria was very dense and especially composed of plasmocytes, and because there was a very important and polyclonal rise of immunoglobulin A (32 g/L) in the serum. A review of the literature allows to consider the immunopathology of coeliac disease. Such a case was never found among the adults. Two similar observations have been described in children.