Pleuro-pericarditis Revealing Celiac Disease

Wafa Ben Saada¹, Fatma Derbali^1, , Nawrez Kammoun¹, Raouf Hajji¹, Sana Triki¹, Monia Elleuch¹, Saida Zribi¹, Mohammed Jallali¹ and Rim Masmoudi¹

¹Internal Medecine Department, Regional Hospital of Sidi Bouzid, Tunisia

Cite this paper:
Wafa Ben Saada, Fatma Derbali, Nawrez Kammoun, Raouf Hajji, Sana Triki, Monia Elleuch, Saida Zribi, Mohammed Jallali and Rim Masmoudi. Pleuro-pericarditis Revealing Celiac Disease. International Journal of Celiac Disease. 2017; 5(1):35-39. doi: 10.12691/ijcd-5-1-10

Abstract

Background: Celiac disease (CD) is an auto immune disease that often one or more disorders may be associated especially endocrine but also heart disorders. We report a patient case with idiopathic hypo-parathyroidism and CD revealed by pleuro-pericarditis. Observation: A 23-year-old woman was admitted in intensive care unit for epileptic-evil condition following dyspneising pleurisy. She has been diagnosed as epileptic case since 5 years and she had undergone surgery for right cataract. On the physical examination, she exhibited a tachycardia and breathing rales at pulmonary auscultation. She had clinical signs of chronic hypocalcaemia, without gastrointestinal complaints. Chest x-ray revealed cardiomegaly and right pleurisy. The cardiac ultrasound demonstrated very abundant bilateral pleural and pericardial effusion. The phosphocalcic balance resulted in a severe hypocalcemia at 0.8 mmol / l and hypo-parathyroidism was confirmed. In addition to the surgical drainage, she had calcium and vitamin D supplementation. CD was suspected after the resistance for a high supplementation and confirmed by endoscopy. Under a gluten-free diet (GFD), the evolution was marked by the stability of serum calcium levels and disappearance of pleural and pericardial effusion. Conclusion: The possibility of celiac disease should be considered in patients with hypoparathyroidism and pericarditis that seems unduly difficult to treat. This should be evaluated even in the absence of gastrointestinal symptoms.

Keywords:
hypocalcoemia malabsorption syndrome pleuro-pericarditis hypoparathyroidism celiac disease

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