Bone fractures are not uncommon in paediatric age. However, when recurrent, an underlying clinical condition must not be excluded. We describe the case of a boy aged 7 years, referred for investigation of recurrent bone fractures. Personal and family histories were unremarkable. Physical examination was normal. Almost all primary bone disorders were excluded. Additional laboratory investigations ruled out the majority of secondary causes of bone fragility. Coeliac disease (CD) serologies, however, were positive, and duodenal biopsies confirmed this diagnosis (Marsh III B). On a gluten-free diet, he suffered no more fractures and the bone mineral density improved. CD was also confirmed in his asymptomatic older brother. It is essential to diagnose CD as early as possible in order to minimise the compromise in bone health and prevent other complications of the disease. First-degree relatives should always be screened for the disease, even asymptomatic ones.
Hemangioma is the most common benign tumor affecting the liver in 7% of general population. One of the rare presentations of this pathology is gigantic liver hemangioma, reported in the literature as anecdotal cases. In selected cases, liver transplantation has been a therapeutic option. We herein describe a case of massive liver hemangioma which was submitted to liver transplant, and the main indication for liver transplant in this case was a severe psychosocial impact of the disease in the patient's life, altogether with Kasabach-Merritt syndrome and abdominal discomfort.
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