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Maria Stella Graziani

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Martina Zaninotto

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Ferruccio Ceriotti
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Matteo Vidali

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Giuseppe Agosta

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Chiara Riva
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ISSN print: 0393 – 0564
ISSN digital: 0392- 7091

BC: Articoli scritti da C. Matinato

Una diagnosi in laboratorio
A case of atypical celiac disease with hematological involvement
<p>We report a case of a pregnant 39 year-old woman (22th week) with leuco-granulocitopenia, iron-deficiency anemia and a slight elevation of transaminases, lasting for several years. The origin of these biochemical alterations was unclear. Assuming a possible autoimmune condition, she underwent a hematological counselling in order to verify the presence of an immunological disorder. Anti-nuclear antibodies resulted negative with a citoplasmic filamentous fluorescence suggestive of anti-smooth muscle antibodies (ASMA). On a suitable substrate for ASMA detection, a reticulin-like fluorescence was observed, inducing to investigate for the presence of celiac disease (CD). CD diagnosis requires both the biochemical tests and duodenal biopsy; however, because of the pregnancy only the serum panel was performed (serum IgA, anti-tissue transglutaminase IgA, anti-endomisium IgA). As the tests were all positive, clinicians decided to start the gluten free diet with an improvement of the hematological and biochemical parameters. The patient gave birth to a healthy newborn.</p>
Biochimica Clinica ; 42(1) e08-e011
Casi clinici - Case report