Diagnostic challenges of celiac disease in a young child: A case report and a review of the literature

Medicine
Cristina Oana MărgineanMaria Oana Mărginean

Abstract

Celiac disease is a chronic, immune-mediated, multiorgan disorder that affects susceptible individuals, and it is triggered by gluten and other prolamins. We present the case of a 1-year-old male child, with a history of idiopathic pericardial effusion, admitted in our clinic for severe abdominal bloating, irritability, loss of appetite and intermittent diarrheic stools. The clinical findings were: influenced general status, irritability, distended abdomen, and diffuse abdominal tenderness. The initial laboratory tests revealed anemia, leukocytosis, increased inflammatory biomarkers, high levels of transaminases, and hypoalbuminemia. The stool culture identified an enterocolitis with enteropathogenic Escherichia coli (E. coli). We initiated antibiotic treatment, substitution therapy with human albumin and probiotics with initial favorable evolution, but after 1 month, the patient was re-admitted for the persistence of intermittent diarrheic stools and abdominal bloating, when we established the diagnosis of cow's milk protein allergy. We initiated diary-free diet. Unfortunately, the patient was re-admitted after another 8 months, presenting the same clinical and laboratory findings as during the initial admission. We repeated t...Continue Reading

References

Aug 1, 1996·The Journal of Pediatrics·L LeporeA Ventura
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Oct 13, 2006·The American Journal of Gastroenterology·Lars C SteneMarian Rewers
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Nov 13, 2010·Annals of Medicine·Kirsi MustalahtiUNKNOWN Coeliac EU Cluster, Project Epidemiology
Dec 27, 2011·Journal of Pediatric Gastroenterology and Nutrition·S HusbyUNKNOWN European Society for Pediatric Gastroenterology, Hepatology, and Nutrition
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Oct 2, 2014·The New England Journal of Medicine·Elena LionettiUNKNOWN SIGENP (Italian Society of Pediatric Gastroenterology, Hepatology, and Nutrition) Working Group on Weaning and CD Risk
Oct 2, 2014·The New England Journal of Medicine·Sabine L VriezingaM Luisa Mearin
Aug 20, 2015·Nutrients·María Carmen CenitYolanda Sanz
Jan 17, 2017·Pediatric Gastroenterology, Hepatology & Nutrition·Shailja VajpayeeAakash Sharma
Feb 24, 2017·Current Opinion in Clinical Nutrition and Metabolic Care·Caroline R MeijerMaria L Mearin
Jun 24, 2017·American Journal of Epidemiology·Andreas BeyerleinAnette-Gabriele Ziegler
Nov 1, 2017·The American Journal of Gastroenterology·Benjamin LebwohlJonas F Ludvigsson
Feb 3, 2018·European Journal of Pediatrics·Michael W Van KalleveenFrans B Plötz

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Citations

Jan 18, 2020·Current Pediatric Reviews·Atifete Ramosaj-MorinaRenata Zunec

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Methods Mentioned

BETA
biopsies

Software Mentioned

CELIPREV

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