In patients with CKD, longer hospitalization time and lower serum albumin concentration significantly increased the risk of the C. difficile infection. The C. difficile infection, age, the number of used antibiotics, longer hospitalization time, and lower initial serum albumin concentration notably augmented the risk of death. Although the incidence of the C. difficile infection did not correlate with the estimated glomerular filtration rate (eGFR), 67% of patients who tested positive were class 5 of CKD, whereas only 5.7% were class 1.
Celiac disease (CD) is an immune-mediated disease, caused by gluten, occurring in people with genetic predisposition. The course of the disease can vary and includes both intestinal and extra-intestinal manifestations. Many patients are undiagnosed for many years and some of them, in particular with nonspecific symptoms or asymptomatic, might never be diagnosed. We present a rare case of a patient, who's first and practically the only symptom of the disease was a pathological fracture of the ribs. In addition, despite the lack of clinical symptoms of malabsorption syndrome, malnutrition and proteinuria, we observed profound hypoalbuminemia and hypoproteinemia. This case suggests that CD diagnostic should be undertaken in evaluation of every patient with osteoporotic fractures and hypoalbuminemia.
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