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
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International Journal of Celiac Disease. 2018, 6(2), 58-61
DOI: 10.12691/ijcd-6-2-4
Open AccessArticle

A Rare Association of Silent Celiac Disease, Acute Hepatitis and Aplastic Anemia: Case Report and Review of Literature

Amel Tej1, , Imene Akari2, Raoudha Kbaili1, Fehmi Ferhi3, Ibtissem Ghdira4, Samia Tilouche1, Kahloul Najoua1, Jihene Bouguila1 and Lamia Boughamoura1

1Department of pediatrics, Farhat Hached University hospital, Ibn Eljazar street 4000 Sousse, Tunisia

2Department of internal medicine, Farhat Hached University hospital, Ibn Eljazar street 4000 Sousse, Tunisia

3Department of reanimation and surgical resuscitation Farhat Hached University hospital, Ibn Eljazar street 4000, Tunisia

4Department of Immunology, Farhat Hached University hospital, Ibn Eljazar street 4000 Sousse, Tunisia

Pub. Date: June 15, 2018

Cite this paper:
Amel Tej, Imene Akari, Raoudha Kbaili, Fehmi Ferhi, Ibtissem Ghdira, Samia Tilouche, Kahloul Najoua, Jihene Bouguila and Lamia Boughamoura. A Rare Association of Silent Celiac Disease, Acute Hepatitis and Aplastic Anemia: Case Report and Review of Literature. International Journal of Celiac Disease. 2018; 6(2):58-61. doi: 10.12691/ijcd-6-2-4

Abstract

Liver abnormalities are common extra-intestinal manifestations of celiac disease (CD). However, aplastic anemia had been rarely described in this disorder. Here, we report an exceptional case suggesting a rare association between asymptomatic CD, acute hepatitis and aplastic anemia: A Nine-year old girl presented with jaundice of 3 weeks duration and hepatosplenomegaly on physical exam. Investigations revealed an acute liver disorder with high serum transaminases levels. Extensive investigations excluded infectious, metabolic and auto immune as cause of acute liver disease. A celiac disease was diagnosed according to the histological exam of small bowel biopsy. A reversal of hepatic disorder was observed within 2 months after the initiation of Gluten free diet. However, the child developed aplastic anemia, which dramatically worsened despite immunosuppressive therapy. The etiological assessment of aplastic anemia was negative suggesting an association with hepatitis and silent celiac disease that could be explained by a common underlying immune pathological mechanism. Therefore, a screening of CD in acute liver disorder and AA should been considered by clinicians.

Keywords:
celiac disease hepatitis aplastic anemia gluten free diet

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