A 48 year old woman presented with a history of fatigue, regular sputu
m production, and wheeze. High resolution computed tomographic scannin
g of the thorax demonstrated widespread bronchiectasis. Coeliac diseas
e was diagnosed on the basis of an iron deficiency anaemia, subtotal v
illous atrophy on small bowel biopsy, and raised anti-gliadin and anti
-endomysial antibodies. The temporal relationship of her bronchiectasi
s and coeliac disease, and the subsequent stabilisation of her clinica
l symptoms and improvement in pulmonary physiology following treatment
with inhaled corticosteroids, suggests a relationship between the two
conditions which may be due to immunological mechanisms.