International Journal of Celiac Disease
ISSN (Print): 2334-3427 ISSN (Online): 2334-3486 Website: http://www.sciepub.com/journal/ijcd Editor-in-chief: Samasca Gabriel
Open Access
Journal Browser
Go
International Journal of Celiac Disease. 2016, 4(2), 71-73
DOI: 10.12691/ijcd-4-2-9
Open AccessCase Report

Nonspecific Symptoms in Celiac Disease- Case Report

Valentina Sas1, Camelia I. Bud2, , Ioana Fodor2 and Sorin C. Man1

1Mother and Child Department, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania

2Third Pediatric Clinic, Emergency Clinical Hospital for Children, Cluj-Napoca, Romania

Pub. Date: May 28, 2016

Cite this paper:
Valentina Sas, Camelia I. Bud, Ioana Fodor and Sorin C. Man. Nonspecific Symptoms in Celiac Disease- Case Report. International Journal of Celiac Disease. 2016; 4(2):71-73. doi: 10.12691/ijcd-4-2-9

Abstract

Celiac disease is an immune-mediated systemic disorder with a genetic predisposition. The availability of more specific serology tests showed that celiac disease is more common than previously suspected and that many patients do not demonstrate specific clinical or even histological sings. We present a case of celiac disease with the unset at 5 years, with recurrent episodes of diarrhea, weight loss and anemia. The serology tests showed a high level of IgA tissue transglutaminase antibodies, exceeding 10 times the upper limit but the intestinal biopsy showed normal size villi, intact surface epithelium and a lymphoplasmacytic infiltrate at chorionic level (Marsh 1). The diagnosis of celiac disease was confirmed by resolution of symptoms and normal tissue transglutaminase antibodies level, six month after starting the gluten free diet.

Keywords:
celiac disease children diagnosis challenge

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Husby, S., et al., European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr. 54(1): p. 136-60.
 
[2]  Van de Wal, Y., et al., Small intestinal T cells of celiac disease patients recognize a natural pepsin fragment of gliadin. Proc Natl Acad Sci U S A, 1998. 95(17): p. 10050-4.
 
[3]  Dieterich, W., et al., Identification of tissue transglutaminase as the autoantigen of celiac disease. Nat Med, 1997. 3(7): p. 797-801.
 
[4]  Dobru, D., et al., The prevalence of coeliac disease at endoscopy units in Romania: routine biopsies during gastroscopy are mandatory (a multicentre study). Rom J Gastroenterol, 2003. 12(2): p. 97-100.
 
[5]  Rubio-Tapia, A., et al., The prevalence of celiac disease in the United States. Am J Gastroenterol. 107(10): p. 1538-44; quiz 1537, 1545.
 
[6]  Mustalahti, K., et al., The prevalence of celiac disease in Europe: results of a centralized, international mass screening project. Ann Med. 42(8): p. 587-95.
 
[7]  Garcia-Manzanares, A. and A.J. Lucendo, Nutritional and dietary aspects of celiac disease. Nutr Clin Pract. 26(2): p. 163-73.
 
[8]  Di Tola, M., et al., Antitissue transglutaminase antibodies in acute coronary syndrome: an alert signal of myocardial tissue lesion? J Intern Med, 2008. 263(1): p. 43-51.
 
[9]  Dahlbom, I., et al., Prediction of clinical and mucosal severity of coeliac disease and dermatitis herpetiformis by quantification of IgA/IgG serum antibodies to tissue transglutaminase. J Pediatr Gastroenterol Nutr. 50(2): p. 140-6.
 
[10]  Vivas, S., et al., Duodenal biopsy may be avoided when high transglutaminase antibody titers are present. World J Gastroenterol, 2009. 15(38): p. 4775-80.
 
[11]  Kurppa, K., et al., Diagnosing mild enteropathy celiac disease: a randomized, controlled clinical study. Gastroenterology, 2009. 136(3): p. 816-23.
 
[12]  Rashid, M. and A. MacDonald, Importance of duodenal bulb biopsies in children for diagnosis of celiac disease in clinical practice. BMC Gastroenterol, 2009. 9: p. 78.
 
[13]  Freeman, H.J., Adult celiac disease and the severe "flat" small bowel biopsy lesion. Dig Dis Sci, 2004. 49(4): p. 535-45.
 
[14]  Harris, L.A., et al., Celiac disease: clinical, endoscopic, and histopathologic review. Gastrointest Endosc. 76(3): p. 625-40.