Hyperamylasemia, Reactive Plasmacytosis, and Immune Abnormalities in a Patient with Celiac Disease

Excerpt

Celiac disease (CD) is an autoimmune disease that occurs in genetically predisposed individuals, characterized by a permanent intolerance to ingested wheat gluten or related proteins from rye and barley, and immunologically mediated inflammatory damage of the small intestinal mucosa [1]. Environmental factors such as gluten administration in childhood and breastfeeding play a synergetic role in the induction of disease. Serologic surveys have shown that CD is a common disease, possibly affecting ∼1% of the population [2], whereas overt CD is rare, suggesting a high proportion of subclinical disease. Here we report a case of CD who demonstrated persistently elevated levels of serum amylase and lipase, reactive plasmacytosis in the bone marrow, and hypergammaglobulinemia characterized by increased levels of serum immunoglobulin (Ig) A and IgG. Immunoprecipitation assay showed that amylase was bound to polyclonal IgG and IgA, whereas lipase was bound to polyclonal IgA. To the best of our knowledge, this is the first report on a Chinese patient with CD, living in China, demonstrating hyperamylasemia together with reactive plasmacytosis, hypergammaglobulinemia, and immune abnormalities. …