Specific Autoantibodies to Gut Epithelium in Two Infants with Severe Protracted Diarrhoea

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Abstract
Two male infants with severe protracted diarrhea presenting at 4 mo. (patient 1) and 10 wk (patient 2) of age are reported. In both patients jejunal biopsy showed subtotal villous atrophy. Both had specific complement-fixing autoantibodies reacting by immunofluorescence with human duodenal, jejunal, and colonic epithelium. Patient 1 also had hypothyroidism and type 1 diabetes mellitus with thyroid and islet cell autoantibodies. His gut antibodies were of IgG class, reached a titer of 1:512, and remained positive throughout his illness. He died at 16 mo. of age. Patient 2 had gut antibodies of IgM class, which reached a titer of 1:128 and disappeared at the time of spontaneous recovery of the diarrhea. An autoimmune process seemed the basis for the enteropathy in these patients. Autoantibody tests should be performed in infants with unexplained protracted diarrhea.