A case of celiac disease presenting with celiac crisis: rare and life threatening presentation

Celiac crisis is a rare, acute, and life-threatening presentation of celiac disease. Its clinical presentations consist of severe watery non-bloody diarrhea, electrolyte disturbances (i.e. hypokalemia, hyponatremia, hypomagnesemia, hypocalcemia, and metabolic acidosis), hypoproteinemia, and dehydration. Here we present a 33-year-old woman who referred with profuse diarrhea, weight loss, hemodynamic instability, hypokalemia, hypoproteinemia, ascites, pancytopenia, and iron deficiency anemia. She used herbal medicines for constipation and had severe weakness after her childbirth. The patient was diagnosed as having celiac disease through pathological and serological evaluations 10 months earlier. Diagnosis of celiac crisis after ruling out the other causes of resistant celiac was made and she was treated with steroids.

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Urinary Tract Infection Associated with a Celiac Crisis: A Preceding or Precipitating Event

Case Reports in Gastroenterology ◽

10.1159/000475921 ◽

2017 ◽

Vol 11 (2) ◽

pp. 364-368 ◽

Cited By ~ 3

Author(s):

Abhinav Tiwari ◽

Khola Qamar ◽

Himani Sharma ◽

Sameh Bashar Almadani

Keyword(s):

Urinary Tract Infection ◽

Celiac Disease ◽

Urinary Tract ◽

Tract Infection ◽

Metabolic Disturbances ◽

Metabolic Derangement ◽

Celiac Crisis ◽

Life Threatening

Celiac crisis is a rare life-threatening presentation of celiac disease that manifests as profuse diarrhea, hypoproteinemia, and severe metabolic disturbances. It may be precipitated by a general immune stimulus such as surgery, infection, or pregnancy. We report the case of a 26-year-old woman who presented with a celiac crisis, potentially triggered by a preceding urinary tract infection. Metabolic derangement is caused by malabsorption and profuse diarrhea, which can be unremitting unless the celiac crisis is recognized, and treatment with gluten restriction is initiated.

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Celiac crisis in patients with celiac disease. Case report

Terapevticheskii arkhiv ◽

10.26442/00403660.2021.08.200972 ◽

2021 ◽

Vol 93 (8) ◽

pp. 943-948

Author(s):

Aleksandra V. Babanova ◽

Larisa M. Krums ◽

Svetlana V. Bykova ◽

Asfold I. Parfenov ◽

Galina A. Dudina ◽

...

Keyword(s):

Celiac Disease ◽

Villous Atrophy ◽

Intensive Therapy ◽

Fresh Frozen Plasma ◽

Strict Adherence ◽

Celiac Crisis ◽

Disease Case ◽

Fresh Frozen ◽

Life Threatening ◽

Frozen Plasma

Celiac crisis (CC) is a rare life-threatening course of celiac disease, observed mainly in children. In adults, CK can be the first manifestation of the disease and, very rarely, a relapse that occurs in patients who do not follow the gluten-free diet (AGD). Triggers can be stress, surgery, childbirth, etc. A clinical observation of CC developed in a 49-year-old patient with previously established latent celiac disease with subtotal villous atrophy, stage Marsh III C is presented. The patient did not comply with AHD. After severe angina, she developed anorexia, diarrhea, emaciation, coagulopathy, bilateral pulmonary embolism, infarction pneumonia, and enterogenic sepsis. As a result of intensive therapy with prednisolone, Fraxiparine, antibiotics, fresh frozen plasma and strict adherence to hypertension, remission of the disease was achieved.

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Severe Alveolar Hemorrhage – What’s in it for the Gastroenterologist?

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.254.cut ◽

2016 ◽

Vol 25 (4) ◽

pp. 555-558

Author(s):

Alina Popp

Keyword(s):

Celiac Disease ◽

International Normalized Ratio ◽

Gluten Free Diet ◽

Alveolar Hemorrhage ◽

Severe Anemia ◽

Gluten Free ◽

Pulmonary Infiltrates ◽

Pulmonary Hemosiderosis ◽

Threatening Condition ◽

Life Threatening

Background: Alveolar hemorrhage is a potentially life-threatening condition which is usually managed by the pulmonologist. When considering its etiology, there is a rare association that sets the disease into the hands of the gastroenterologist. Case presentation: We report the case of a 48 year-old female who was admitted to the intensive care unit for severe anemia and hemoptysis. On imaging, diffuse pulmonary infiltrates suggestive of alveolar hemorrhage were detected and a diagnosis of pulmonary hemosiderosis was made. She received cortisone therapy and hematologic correction of anemia, with slow recovery. In search of an etiology for the pulmonary hemosiderosis, an extensive workup was done, and celiac disease specific serology was found positive. After confirmation of celiac disease by biopsy, a diagnosis of Lane-Hamilton syndrome was established. The patient was recommended a gluten-free diet and at 6 months follow-up, resolution of anemia and pulmonary infiltrates were observed. Conclusion: Although the association is rare, celiac disease should be considered in a patient with idiopathic pulmonary hemosiderosis. In our case, severe anemia and alveolar infiltrates markedly improved with glucocorticoids and gluten-free diet. Abbreviations: APTT: activated partial thromboplastin time; BAL: bronchoalveolar lavage; CD: celiac disease; Cd: crypt depth; GFD: gluten-free diet; GI: gastrointestinal; IEL: intraepithelial lymphocyte; INR: international normalized ratio; IPH: idiopathic pu

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Celiac crisis: a rare and life-threatening condition

European Journal of Gastroenterology & Hepatology ◽

10.1097/meg.0000000000002266 ◽

2021 ◽

Vol 33 (12) ◽

pp. 1612-1613

Author(s):

Isabel Garrido ◽

Ana Luísa Santos ◽

João Pacheco ◽

Armando Peixoto ◽

Guilherme Macedo

Keyword(s):

Celiac Crisis ◽

Threatening Condition ◽

Life Threatening

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Celiac Crisis in an Adult: Raising Awareness to a Life-Threatening Condition

European Journal of Case Reports in Internal Medicine ◽

10.12890/2016_000384 ◽

2016 ◽

Vol 3 (2) ◽

Cited By ~ 2

Author(s):

Rogerio Ferreira ◽

Rui Pina ◽

Nelson Carvalho ◽

Armando Carvalho

Keyword(s):

Celiac Crisis ◽

Raising Awareness ◽

Threatening Condition ◽

Life Threatening

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Rotavirus gastroenteritis as a precipitating factor of celiac crisis in infancy - case reports and review of literature

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh200802101l ◽

2020 ◽

pp. 101-101

Author(s):

Zoran Lekovic ◽

Vladimir Radlovic ◽

Nevena Jovicic ◽

Goran Djuricic ◽

Marija Mladenovic ◽

...

Keyword(s):

Celiac Disease ◽

Villous Atrophy ◽

Case Reports ◽

Failure To Thrive ◽

Complete Recovery ◽

Latex Agglutination ◽

Watery Diarrhea ◽

Rapid Improvement ◽

Rotavirus Gastroenteritis ◽

Celiac Crisis

Introduction. Celiac crisis is a rare and life-threatening complication of celiac disease. Although it occurs in all ages, the most common affects children within the first two years. Outline of cases. We report three infants (two female, one male, age range 9-12) with celiac crises as an initial presentation of celiac disease precipitated with rotavirus gastroenteritis. Celiac crisis was preceded by failure to thrive caused by anorexia, occasional vomiting and frequent abundant stools for 4-8 weeks, and 1-2 days before admission with fever, frequent vomiting and profuse watery diarrhea. They were admitted in a very severe general condition, severely dehydrated, markedly malnourished, with an enormously distended abdomen, edema of the lower legs and feet, and perianal erythema. After correction of dehydration and hypoalbuminemia, they were placed on a gluten- and disaccharide-free diet and within the first 2 weeks on additional parenteral nutrition. The applied therapeutic measures resulted in stabilization and further rapid improvement of the patient's condition. In all three patients the latex agglutination test for rotavirus was positive, IgA anti-TTG antibodies elevated (58.6 to 78 U/ml) and all three were homozygous carriers of the HLA DQ2 gene. Enterobiopsy was performed two weeks after admission and total villous atrophy (Marsh IIIc) was registered in all three patients. In the further course, on a strict gluten-free diet, the complete recovery of the patient followed. Conclusion. Our experience indicates that rotavirus gastroenteritis in timely unrecognized classical celiac disease in infants can lead to celiac crisis.

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