Coeliac crisis mimicking nephrotic syndrome in a post-partum patient

Helvacı, Özant; Yıldız, Şeyma; Korucu, Berfu; Derici, Ülver; Arınsoy, Turgay

doi:10.1177/0036933019853170

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…Although relatively uncommon, initial presentation during pregnancy or postpartum period has been described in the literature. [4][5][6][7][8] Most women presenting with CD during pregnancy or the postpartum period had previous signs or symptoms suggestive of CD since childhood that were mild or transient. 5 Common triggers for subclinical CD to manifest include surgery, gluten overloading, smoking cessation, and infection, 7 and the postpartum period should be added to this list.…”

Section: Discussionmentioning

confidence: 99%

“…A review of the literature identified 48 cases of adults presenting with celiac crisis, 9 but only one case was reported during the postpartum period. 6 Celiac crisis requires urgent hospitalization, fluid resuscitation, correction of electrolyte imbalances, and nutritional support with close monitoring for refeeding syndrome. All cases dramatically improved with a gluten-free diet, and only 1 death was reported (mortality of 2%).…”

Section: Discussionmentioning

confidence: 99%

“…3 However, CD rarely presents during pregnancy, and few cases of fulminant CD, or celiac crisis, have been reported during the postpartum period. [4][5][6] We report a case of celiac crisis with a life-threatening presentation postpartum.…”

Section: Introductionmentioning

confidence: 99%

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Fulminant Celiac Disease Presenting in the Postpartum Period

Kuwelker,

Soni,

Perez-Sanchez

et al. 2024

ACG Case Rep J

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Celiac disease (CD) is an immune-mediated disorder of the small intestine triggered by dietary exposure to gluten in genetically susceptible individuals. Adult CD usually has an insidious onset with gastrointestinal symptoms, most often diarrhea and weight loss. The association between CD and reproductive abnormalities has been well described in the literature, but it is uncommon for CD to initially manifest during pregnancy or the postpartum period. We report a case of adult CD in a previously healthy woman with a life-threatening presentation during the postpartum period.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Fulminant Celiac Disease Presenting in the Postpartum Period

Kuwelker,

Soni,

Perez-Sanchez

et al. 2024

ACG Case Rep J

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“…Since completing a GFD, two patients were seriously affected, one with mild biochemical and histological (pathological) benefits, and the other with moderate biochemical and histological (pathological) benefits. Cholesterol tends to play a role in the prevalence of autoimmune disease, which affects between 3.5 percent and 33.3 percent of the population [18][19] . People who demonstrate that CLD or hypertransaminasinemia exists in cases of AILD, patients, other people with AILD, and people who have no clear or apparent reasons for AILD should all be included in the screening process, according to current and previous studies [20][21] .…”

Section: Discussionmentioning

confidence: 99%

Coeliac Disease and the Liver: Spectrum of Liver Serology, Histology and Response of Treatment with Gluten-Free Diet

Iqbal¹,

Anjum²,

Joher³

et al. 2021

PJMHS

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Aim: To evaluate the histological spectrum of "celiac hepatitis" and the likelihood that these features will return after GFD. Methods: The laboratory tests, Clinical profile, liver and duodenal biopsy were studied with the patients with hepatic derangement and CD among 35 patients. Whenever possible, a histological comparison of before and after GFD treatmenton liver and duodenal biopsies were performed. Results: In the records of the pathology and gastroenterology departments of our institute, CD and ECM were found in 35 patients. There were twenty-four men and 11 women with a mean age of 24.3 (10-50 range). Twenty-four patients were primarily identified with celiac disease and later diagnosed with CLD. At diagnosis, this feature was currently associated with small bowel diarrhea in 13 (65%) and CD without diarrhea in the remaining seven patients (35%). 10 of these 20 patients had anemia. Antibodies to TTG were positive in 21 patients (87.5%), AGA in 17 patients (70.8%), and EMA in 4 patients. Severe villous abnormality (Marsh-Oberhuber type 3C) in eleven patients (45.8.3%) on duodenal biopsy, moderate villous abnormality (type 3B) in seven patients (29.2%), 5 patients (20.8%) have mild abnormality of the villi (type 3A). The clinical topographies indicating the progress of liver ailment in these 24 cases are as follows: 8 have ascites (33.3%), 6(25%) patients have jaundice, hepatomegaly in 5 (20.8%) and 5(20.8%) Patients have splenomegaly. Conclusion: There has been a problematic case of coeliac disease that has undergone an unnoticed distinction. This is one of the few researches that shows the full range of Coeliac Disease liver histopathology, from non-invasive to invasive hepatitis’. Experiment of a GFD may outcome in clinicopathological enhancement of ’coeliac hepatitis’. Keywords: Gluten-free diet, coeliac disease, duodenal biopsies, hepatomegaly.

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Life-threatening onset of coeliac disease: a case report and literature review

Guarino

Gambuti

Alfano

et al. 2020

BMJ Open Gastroenterol

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BackgroundCoeliac disease (CD) results from an immune-mediated reaction to gluten in genetically predisposed individuals. In rare cases CD may occur with acute features deferring the diagnosis and exposing these patients to possible life-threatening complications. Herein we present the case of a young woman with a coeliac crisis, that is, a sudden clinical onset characterised by severe electrolyte imbalance due to an unknown (previously unrecognised) CD.MethodsThis is a case report and literature review revealing that coeliac crisis is under-reported, with a total of 48 adult cases so far published. The diagnosis in our case was established by histopathological analysis of multiple duodenal biopsies. The patient’s serum was tested by enzyme-linked immunoassay to detect antitransglutaminase IgA antibodies.ResultsIn contrast to cases reported in the literature, with male gender predominance and a mean age of 50±17 years, our patient was a young female case of coeliac crisis. However, like in our patient, a higher incidence of coeliac crisis was associated with the human leucocyte antigen (HLA)-DQ2 haplotype, versus HLA-DQ8, and a severe (Marsh-Oberhüber 3c) duodenal mucosa atrophy. Notably, there is no clear correlation between the antitissue transglutaminase 2 IgA antibody titre and coeliac crisis onset/severity, as confirmed by our case report.ConclusionsThe present case highlights that CD may manifest quite abruptly with a severe malabsorption syndrome, that is, electrolyte abnormalities and hypoproteinaemia. Our case should alert physicians, in particular those in the emergency setting, that even a typically chronic disorder, such as CD, may show life-threatening complications requiring urgent management.

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Coeliac crisis mimicking nephrotic syndrome in a post-partum patient

Cited by 4 publications

References 7 publications

Fulminant Celiac Disease Presenting in the Postpartum Period

Fulminant Celiac Disease Presenting in the Postpartum Period

Coeliac Disease and the Liver: Spectrum of Liver Serology, Histology and Response of Treatment with Gluten-Free Diet

Life-threatening onset of coeliac disease: a case report and literature review

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