[Acute diarrhoea revealing a coeliac disease]

The classical mode of revelation of a coeliac disease is chronic diarrhoea. We report the case of a patient in whom acute diarrhoea revealed the disease.

In a 40 year-old man with acute diarrhoea with 7 non-bleeding stools per day, upper digestive tract endoscopy showed a villosity atrophy aspect confirmed by the histological examination. The search for specific antibodies of a coeliac disease was positive. A gluten-free diet led to the disappearance of the diarrhoea, followed by the disappearance of the specific antibodies and the regression of the villosity atrophy.

Acute diarrhoea that resists medical treatment must evoke the hypothesis of a coeliac disease and lead to a gastroscopy with duodenal biopsies. The interest of evoking the diagnosis is not only in order to obtain the rapid disappearance of the clinical signs after the introduction of a gluten-free diet but also to avoid an increase in the high risk of malignant lesions of the small intestine.