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Published on: June 28, 2021
[Celiac crisis and acute tetany in pediatrics. Case report]
Agustina Del Rosario Sbruzzi1, Federico Torres1, Horacio Sommaruga2
1Hospital General de Niños Pedro de Elizalde. Buenos Aires, Argentina.
Insights
Celiac crisis, a severe form of celiac disease, presents with acute malnutrition and metabolic issues. Early diagnosis requires high suspicion due to its potentially fatal presentation.
Area of Science:
- Gastroenterology
- Pediatric Medicine
- Immunology
Background:
- Celiac disease is an immune-mediated condition with diverse clinical manifestations.
- Celiac crisis represents an acute, life-threatening presentation of celiac disease.
- Characterized by severe diarrhea, dehydration, and metabolic derangements.
Observation:
- A 7-year-old male presented with tetany, edema, steatorrhea, and weight loss.
- Laboratory findings revealed hypocalcemia, hypomagnesemia, hypokalemia, and coagulopathy.
- Symptoms had an 8-month duration prior to admission.
Findings:
- Diagnosis of celiac crisis was established based on clinical and serological evidence of celiac disease.
- Severe metabolic abnormalities and acute malnutrition were key diagnostic factors.
- Pathological anatomy confirmed the diagnosis.
Implications:
- Highlights the critical need for a high index of suspicion in diagnosing celiac crisis.
- Underscores the severe systemic impact of untreated or undiagnosed celiac disease.
- Emphasizes the importance of recognizing celiac crisis as a medical emergency.
Abstract:
Celiac disease is an immune-mediated systemic disease with a wide spectrum of clinical presentations. The term celiac crisis describes the acute and potentially fatal form. Clinically it is characterized by severe diarrhea, dehydration, and metabolic disturbances. The case of a 7-year-old male patient attending the ward with tetany, lower limb edema, steatorrhea and weight loss of 8 months of evolution is reported, with analytical findings of hypocalcemia, hypomagnesemia, hypokalemia and coagulopathy. The diagnosis of celiac crisis was made on the basis of serological and clinical findings compatible with celiac disease in the context of severe metabolic abnormalities and acute malnutrition, later confirmed by pathological anatomy. The importance of this report lies in reviewing the characteristics of this serious entity, which requires a high index of suspicion for its diagnosis.
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