Celiac disease in toddler with atypical onset. Case report.

Abstract

Celiac disease is a chronic immune-mediated disorder induced in genetically susceptible individuals after ingestion of gluten proteins. An early diagnosis is of highest importance. Ultrasound might show small-bowel intussusception. We present a toddler with one month history of diarrhea and abdominal ultrasound showing ileo-ileal intussusception. Specific serological markers for celiac disease were positive. The duodenal endoscopy showed normal architecture but pathology indicated fully developed celiac disease (Marsh 3c). In conclusion, toddlers, who have even a short history of diarrhea with ultrasound showing ileo-ileal intussusception, can be suspected of celiac disease by positive serologic markers and can be confirmed by duodenal biopsy and pathology.

Celiac disease - a pluripathological model in pediatric practice

“…Although its clear frequency could not yet be established, the association between the two pathologies is certified by numerous reported cases ( 151 – 154 ). It is noted that the risk factors associated with this are age and low weight, diarrhea at presentation, abdominal distension, rickets, low serum albumin, severe villous atrophy and refeeding syndrome ( 155 , 156 ). The risks in the dynamics are represented by the recurrence of symptoms, intestinal obstruction and acute surgical abdomen.…”

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“…The classic form of the disease is diagnosed using serologic and histopathologic tests [5]. Anti-tissue transglutaminase antibody (anti-tTG), as the most sensitive and specific serology study, is used in suspected cases [1][2][3][4]. A positive serology study must be followed by endoscopy of the small intestine.…”