The Gut-gut Axis: Cohabitation of Celiac, Crohn’s Disease and IgA Deficiency

An adult patient with IgA deficiency, celiac and Crohn’s disease is described. In addition to the rare association, he developed an unusual proximal Crohn’s disease. Unbalanced microbiome, increased intestinal permeability, susceptibility to infections that might initiate post translational modification of naïve protein and the genetic background, are shared between the three entities. It is speculated that the IgA immune deficiency and its consequences are the early factors that set the stage for the progression of the other two diseases. Based on recent knowledge, special nutritional therapies should be considered, in addition to the gluten free diet.