Late discovered celiac disease in an elderly patient with histopathological changes of the terminal ileum
DOI:
https://doi.org/10.6016/ZdravVestn.3412Keywords:
gluten-free diet, chronic diarrhea, celiac crisis, villous atrophy, tissue transglutaminaseAbstract
Celiac disease is a chronic autoimmune disease that affects the small intestine in patients with a genetic predisposition when consuming gluten. It can occur at any age, in women and men. We present a clinical case of a patient with late-onset celiac disease manifested by weight loss, chronic diarrhoea, and histological examination of mucosal samples from the terminal ileum. The patient presented with severe dehydration, orthostatic hypotension, metabolic acidosis, renal insufficiency, electrolyte imbalance, and vitamin K deficiency. The aforementioned conditions in patients with known celiac disease are called celiac crisis. The condition occurred after a complicated fracture, surgery, and long-lasting antibiotic treatment, which are all known triggers for celiac crisis. After applying the gluten-free diet, we observed fast improvement in the patient’s clinical condition; the laboratory tests also showed improvement in malabsorption. In our case, we would like to admonish that the clinical manifestation of chronic diarrhoea in the 8th decade of life can also be caused by celiac disease.
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