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Unexpected cause of dyspnoea in a patient with allergic rhinitis
  1. Vesna Vukičević Lazarević1,2,
  2. Ana Marija Šola2 and
  3. Ivan Vlahović3
  1. 1Imperial College London Faculty of Medicine, London, UK
  2. 2Special Hospital for Pulmonary Diseases, Zagreb, Croatia
  3. 3Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, Essex, UK
  1. Correspondence to Dr Vesna Vukičević Lazarević; vukicevic_vesna{at}


A defect in one part of the immune system may affect the whole system. As a result, there may be a myriad of immunological diseases, which are often masked with the one disease that has the most prominent symptoms. This case report presents a patient with long-lasting allergic rhinitis who recently developed dyspnoea in exertion with suspected asthma development. After extensive diagnostic processing, asthma was dismissed, and diagnosis of selective IgA deficiency and coeliac disease with consequential iron deficiency anaemia was established. The patient was treated with parenteral iron and a gluten-free diet, which corrected her anaemia and led to the disappearance of dyspnoea. This paper aims to show the interplay between different immunological disorders and the possible causal connection between them.

  • ear
  • nose and throat
  • general guidance on prescribing
  • respiratory system
  • coeliac disease
  • immunology

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  • Contributors AMŠ was involved in treating this patient and provided a lot of data for this case report. Also, she was involved in the writing of this paper. IV provided good clinical advice while treating this patient and was involved in writing and reviewing this paper. VVZ is the first author and corresponding author of this paper and treating physician.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.