Antinuclear antibodies are autoantibodies directed against cellular autoantigens. They are detected by indirect immunofluorescence technique. In case of positivity, the antigenic target must be identified. In this work we report the case of antinuclear antibody positivity without defined antigenic target. The patient was 56 years old and came to the department of internal medicine because of a worsening of her late-onset asthma, which had been followed for 3 years, with the appearance of myalgias, arthralgias, photosensitivity and dry eyes, which led to the suspicion of an autoimmune disease. Biological examinations showed an elevation of CRP and sedimentation rate, normal blood count, normal hemostasis, renal and hepatic tests were also without particularities. Immunological tests for rheumatoid factor and anti-CCP antibodies were negative. The anti-nuclear antibody test was positive on two occasions at 640 and 1280 with a homogeneous appearance. However, the complementary workup to identify antinuclear antibodies was negative: anti-native Dna antibodies, anti-soluble antigen antibodies and myositis profile. Finally, the search for anti-neutrophil cytoplasmic antibodies was positive for p- ANCA with a value greater than 1280. The diagnosis of Churg-Strauss type ANCA vasculitis was retained in our patient in view of the clinical symptoms presented and the positive immunological assessment for p-ANCA.

The prevalence of celiac disease in the general population is 1%, it is more common in patients with type 1 diabetes. Our objective is to determine the prevalence of anti-transglutaminase type IgA antibodies in children with type 1 diabetes. For this, we conducted a descriptive retrospective study, carried out within the laboratory of immunology-serology of the CHU Ibn Rochd of Casablanca. We included all requests for research of anti-transglutaminase type IgA antibodies in children with type 1 diabetes, over a period of 3 years. Our study identified 480 children with type 1 diabetes. The median age was 9 years with extremes of 1 to 14 years, 247 children were male or 51.5% versus 233 female or 48.5%, the sex ratio (M/F) calculated was 1.06. Anti-transglutaminase type IgA antibodies were positive in 70 patients, a prevalence of 14.6%. We compared the seropositive group (n=70) with the seronegative group (n=410). There was no difference between the two groups for age. However, female children were more affected in the seropositive group. This study confirms that celiac disease is common in diabetic patient’s type 1. Early diagnosis of celiac disease is very important to prevent long-term complications. These complications can be prevented by a simple gluten-free diet.