జీర్ణకోశ & జీర్ణ వ్యవస్థ

నైరూప్య

Celiac Disease Associated by a Rare Complication: Case Report

Virtut Velmishi, Albert Koja, Numila Kuneshka, Ermira Dervishi,  Paskal Cullufi

Introduction: Celiac disease, is an autoimmune disorder of the small intestine that occurs in genetically predisposed people. Symptoms include pain and discomfort in the digestive tract, chronic constipation and diarrhoea, failure to thrive, anaemia and fatigue, but these may be absent, and symptoms in other organ systems have been described.

Case Presentation: A two year old girl was admitted at our hospital in March 2013 with a diagnosis of Ascitis and Edema. She has a history of 6 months of being pale and tired. In the last 3 weeks she manifested a severe diarrhea and edema in both her feet. During physical examination the girl looked tired and reacted slowly. She had dry mouth and spare hair. Heart rate was normal but tones intensity was weak. Lungs auscultation was uneventful. Abdomen was very large, distended, liver was 3-4 cm under the costal border,spleen was not palpable. In the low extremities was evident bilateral edema. The child’s weight was 10 kg. IgA antitransglutaminasis was positive for celiac disease. Heart ultrasonography showed an effusive pericarditis which is not a common association with celiac disease.

Conclusion: CD should not be underestimated because sometimes may be complicated by rare but life threatening events like effusive pericarditis. Failing to react and take measures quickly can result in fatality. An association between celiac disease and pericardial effusion is not deescribed before. Every child with pericardial effusion without a clear etiology should be tested for celiac disease.