A rare case of Addison’s disease, hepatitis, thyreoiditis, positive IgG anti-tissue transglutaminase antibodies and partial IgA deficiency

Baleva M, Mihaylova S, Yankova P, Atanasova I, Nikolova-Vlahova M, Naumova E. A rare case of Addison’s disease, hepatitis, thyreoiditis, positive IgG anti-tissue transglutaminase antibodies and partial IgA deficiency. Central European Journal of Immunology. 2016;41(2):217-220. doi:10.5114/ceji.2016.60997.

APA

Baleva, M., Mihaylova, S., Yankova, P., Atanasova, I., Nikolova-Vlahova, M.,  & Naumova, E. (2016). A rare case of Addison’s disease, hepatitis, thyreoiditis, positive IgG anti-tissue transglutaminase antibodies and partial IgA deficiency. Central European Journal of Immunology, 41(2), 217-220. https://doi.org/10.5114/ceji.2016.60997

Chicago

Baleva, Marta P., Snejina Mihaylova, Petja Yankova, Iliana Atanasova, Milena Nikolova-Vlahova,  and Elissaveta Naumova. 2016. "A rare case of Addison’s disease, hepatitis, thyreoiditis, positive IgG anti-tissue transglutaminase antibodies and partial IgA deficiency". Central European Journal of Immunology 41 (2): 217-220. doi:10.5114/ceji.2016.60997.

Harvard

Baleva, M., Mihaylova, S., Yankova, P., Atanasova, I., Nikolova-Vlahova, M.,  and Naumova, E. (2016). A rare case of Addison’s disease, hepatitis, thyreoiditis, positive IgG anti-tissue transglutaminase antibodies and partial IgA deficiency. Central European Journal of Immunology, 41(2), pp.217-220. https://doi.org/10.5114/ceji.2016.60997

MLA

Baleva, Marta P. et al. "A rare case of Addison’s disease, hepatitis, thyreoiditis, positive IgG anti-tissue transglutaminase antibodies and partial IgA deficiency." Central European Journal of Immunology, vol. 41, no. 2, 2016, pp. 217-220. doi:10.5114/ceji.2016.60997.

Vancouver

Baleva M, Mihaylova S, Yankova P, Atanasova I, Nikolova-Vlahova M, Naumova E. A rare case of Addison’s disease, hepatitis, thyreoiditis, positive IgG anti-tissue transglutaminase antibodies and partial IgA deficiency. Central European Journal of Immunology. 2016;41(2):217-220. doi:10.5114/ceji.2016.60997.

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Introduction: Selective IgA deficiency (IgAD) is the most prevalent type of primary immune deficiencies, but partial IgA deficiency is even more common. Addison’s disease is a rare condition associated with primary adrenal insufficiency due to infection or autoimmune destruction of the adrenals. The association between IgA deficiency and Addison’s disease is very rare.

Case and laboratory data: We observed a 22-year-old male patient with marked darkening of the skin, especially on the palms and areolae, jaundice on the skin and sclera, astheno-adynamia, hypotension (80/50 mm Hg), and pain in the right hypochondrium. The laboratory investigations revealed increased serum levels of total and indirect bilirubin, AST, ALT, GGT and LDH, negative HBsAg, anti-HBc IgM, anti-HCV and anti-HAV IgM, very low serum IgA levels (0.16 g/l) with normal IgG and IgM, negative ANA, ANCA, AMA, LKM-1, anti-GAD-60, anti-IA-2, anti-thyroglobulin antibodies, a mild increase in anti-TPO antibodies titer, a marked increase in IgG anti-tissue transglutaminase antibodies, with no typical changes in cellular immunity, negative T-SPOT-TB test, HLA – A*01; B*08; DRB1*03; DQB1*02, karyotype – 46, XY.

Conclusions: We present a rare case of partial IgA deficiency with Addison’s disease, hepatitis, thyroiditis and positive anti-tissue transglutaminase antibodies. IgAD and some autoimmune disorders share several predisposing HLA genes, thus explaining the increased prevalence of IgAD in certain patient groups.

keywords:

A rare case of Addison’s disease, hepatitis, thyreoiditis, positive IgG anti-tissue transglutaminase antibodies and partial IgA deficiency

Marta P. Baleva , Snejina Mihaylova , Petja Yankova , Iliana Atanasova , Milena Nikolova-Vlahova , Elissaveta Naumova

Addison‘s disease, partial IgA deficiency, thyreoiditis, tissue transglutaminase antibodie

Marta P. Baleva

,

Snejina Mihaylova

,

Petja Yankova

,

Iliana Atanasova

,

Milena Nikolova-Vlahova

,

Elissaveta Naumova