Celiac disease (CD) is an autoimmune enteropathy induced by gluten, characterized by a specific genetic genotype (HLA- DQ2 and HLA DQ8). The clinical manifestations are polymorphic with many atypical forms, this leads to difficulty in diagnosis. We report here the case of a patient with known carriers of portal hypertension on hepatic cirrhosis since her young age without any specified cause, admitted at the Gastroenterology Department for hemorrhagic decompensation of her portal hypertension. The immunological assessment and the histology of duodenal biopsies revealed a silent celiac disease.

Introduction: The discovery of hemolytic anemia must lead to a precise etiological assessment guided by clinical and biological data. The aim of our study is to describe the etiological profile of hemolytic anemia cases diagnosed in the hematology laboratory of the Hassan II University Hospital in FEZ. Material and Methods: We conducted a retrospective and descriptive study of hemolytic anemia cases diagnosed between January 2017 and July 2019 and based on epidemiological and clinical data collected from computerized reports and laboratory investigations. Results: The analysis of clinicobiological records identified 100 cases of hemolytic anemias. The mean age of our patients was 36 years , with a sex ratio (F /H) of 1.5. Anemia was symptomatic in the majority of patients. The etiologies found were : neoplasia in 32 patients, systemic lupus erythematosus in 10 patients , sickle cell disease in 10 patients, immunological thrombocytopenic purpura in 7 patients, glucose-6-phosphate dehydrogenase deficiency in 7 patients, alloimmunization in 5 patients, hemolytic uremic syndrome in 5 patients, hyperthyroidism in 5 patients, thalassemia in 4 patients, microspherocytosis in 4 patients, hypersplenism in 4 patients, paroxysmal nocturnal hemoglobinuria in 1 patient , pyruvate kinase deficiency in 1 patient, Gaucher disease in 1 patient, and the use of alpha-methyl Dopa in only one patient. Conclusion: Hemolytic anemia constitute a real diagnostic challenge. Neoplasia predominate in elderly subjects while autoimmune pathologies are more frequent in young subjects.