Coeliac crisis in adults: report of two cases

Adult coeliac disease, in contrast to its childhood counterpart, almost always has an indolent course with a wider spectrum of clinical manifestations. Approximately half of the patients have no overt gastrointestinal symptoms and many are asymptomatic. A rare and life-threatening complication, affecting mainly children younger than 2 years of age, is the so-called coeliac crisis, a term that applies to profuse diarrhoea leading to dehydration, hypokalemia, and acidosis. We report here two cases of adult coeliac disease that presented as coeliac crisis. Coeliac disease should be a differential diagnosis in adult patients with severe acute diarrhoea and acidosis, although a rare presentation.