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- Title
ASSOCIATION BETWEEN MULTIPLE AUTOIMMUNE DISEASES IN THE SAME PATIENT - A CASE REPORT.
- Authors
Mihalache, Mihaela Nicoleta; Mocanu, Andreea; Bodiu, Ionela Georgiana; Maican, Mihaela; Negovan, Anca-Elena
- Abstract
Background: Celiac disease, autoimmune gastritis and vitiligo are immune-mediated diseases. Celiac disease is a disorder triggered by gluten that affects the small intestine causing atrophy of intestinal villi, with a global prevalence of 1-2%. Autoimmune gastritis is a chronic disease that destroys the parietal cells in corpus and fundus of the stomach. The common consequence is vitamin B12 deficiency and pernicious anemia. Vitiligo is a skin disease, resulting from an immune attack on melanocytes, leading to depigmentation. Objective: Our objective is to highlight that autoimmune disorders tend to coexist in the same patient. Material and methods: A 38-year-old female with a medical history of vitiligo, mitral valve prolapse and repeated evaluations for an anemic syndrome was admitted to the emergency department complaining of fatigue, loss of appetite, weight loss - 8 kg in 3 weeks. Laboratory findings revealed a normochromic macrocytic anemia (Hgb: 6,44 g/dl). She received a blood transfusion and was transferred to internal medicine department for investigations. Results: The gastroscopy revealed atrophy in the gastric corpus, smooth mucosa, deformed duodenal bulb with linear erythema, duodenum II - no lesions of the mucosa and atrophic aspect. The histopathological diagnoses were: duodenal mucosa with intraepithelial lymphocytosis (MARSH 1); reactive antral gastropathy; chronic inactive gastritis with intestinal metaplasia, glandular atrophy, nodular and linear hyperplasia of neuroendocrine cells. The test for anti-parietal cell antibodies was positive. She was diagnosed with celiac disease, autoimmune gastritis and Biermer anemia. A gluten free diet was recommended. Conclusions: According to recent studies autoimmune gastritis is associated with other autoimmune disorders such as: Hashimoto's thyroiditis, diabetes type 1, vitiligo, the association with celiac disease is still controversial. These patients should be tested for multiple autoimmune diseases.
- Subjects
ATROPHIC gastritis; VITILIGO; GLUTEN-free diet; AUTOIMMUNE diseases; AUTOIMMUNE thyroiditis; SKIN diseases; DISEASES
- Publication
Acta Medica Marisiensis, 2019, Vol 65, p38
- ISSN
2068-3324
- Publication type
Article