IMMUNOLOGICAL ASPECTS OF A CHILD WITH IDIOPATHIC PULMONARY HEMOSIDEROSIS AND CELIAC-DISEASE

A case report of a girl aged 3.5 years affected by the extremly rare c ombination of idiopathic pulmonary haemosiderosis (IPH) and coeliac di sease (CD) is presented. It is the 13(th) such case that has been publ ished over the last 25 years and only the 7(th) to be reported in a ch ild. We believe that the concurrence of these two diseases is not coin cidental, because a gluten-free diet had beneficial effects on the pul monary symptoms not only in our case but also in other such patients. However, the pathogenetic relation between IPH and CD remains unclear. Although circulating immune complexes were detected in our patient's serum, there was no evidence of their putative damaging effect on the basement membrane of the alveolar capillaries. Furthermore, no IgA dep osits could be demonstrated in alveolar basement membranes. Therefore the hypothesis that there is a reaction between IgA reticulin or endom ysial antibodies and an alveolar basement membrane antigen with consec utive structural damage is unlikely.