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[Celiac disease associated with major thalassemia. A case report]
1Servizio di Talassemia, Azienda Ospedaliera, Umberto I, Siracusa.
Insights
Coeliac disease, an intestinal disorder, is increasingly linked with other conditions. This case highlights the importance of screening thalassemic patients with growth issues for coeliac disease.
Area of Science:
- Pediatric Gastroenterology
- Hematology
- Clinical Medicine
Background:
- Coeliac disease (CD) is a common chronic intestinal disorder in children with diverse clinical presentations.
- Beta-thalassemia is a hematologic disorder often associated with growth impairment despite improved treatments.
- Screening for CD using anti-tissue transglutaminase (tTG) and anti-endomysial antibodies (EMA) is effective in various patient groups.
Observation:
- A case of coeliac disease is presented in an adolescent diagnosed with thalassemia major.
- The patient exhibited symptoms including anorexia, arrested weight gain, and short stature.
- This presentation suggests a potential new association between these two distinct conditions.
Findings:
- The co-occurrence of coeliac disease and thalassemia major was identified in this adolescent patient.
- Growth failure in thalassemic patients may be exacerbated or caused by undiagnosed coeliac disease.
- This case underscores the need for vigilance in identifying coeliac disease in thalassemic individuals experiencing growth deficits.
Implications:
- The findings suggest a previously unrecognized association between coeliac disease and thalassemia major.
- Healthcare providers should consider screening thalassemic patients with poor growth for coeliac disease.
- Early diagnosis and management of coeliac disease can potentially improve growth outcomes in thalassemic children.
Abstract:
The spectrum of clinical manifestations of coeliac disease, the most common chronic intestinal disorder in children, has widened considerably over the past years and new associations with other diseases, both immunological and non-immunological, have been described. AGA and EMA have proved to be an efficient screening method both in populations with gastrointestinal pathologies and in groups of pauci- or even asymptomatic subjects. The clinical picture of beta-thalassemia has gradually altered over the years owing to improved treatment. However, growth is still affected in a considerable proportion of thalassemic patients. A number of hormonal and other causes, combined in varying ways, contribute to determining this clinical condition. The authors report a case of coeliac disease in an adolescent with thalassemia major characterised by anorexia, arrest of weight gain and low stature. The identification of a new association between coeliac disease and thalassemia major highlights the need to search for this pathology in all thalassemic patients who present scarce growth in stature and weight.