Conglomeration of Symptomatic Crohn’s Disease and Celiac Sprue: a Case Report from Western India and Review of the Literature

Abstract

Background: Background: Celiac diseases are found to be associated with other autoimmune diseases such as autoimmune thyroiditis, type I diabetes, Addison’s disease, primary biliary cirrhosis, and inflammatory bowel disease (IBD). In literature, only a few cases were described simultaneously presenting both conditions in the same patient. Case Presentation:: A 23-year-old Indian male presented with a one-month history of loose motion 10-12 times per day, having watery stool, and nocturnal diarrhea. The patient had pallor, weakness, fatigability, and anorexia/weight loss. The patient also had a history of periumbilical pain abdomen and black-colored stools. In our study, both conditions are clinically symptomatic in the same patient, as proved by endoscopic changes and histopathologically. Esophagogastroduodenoscopy (EGD) examination shows severe scalloping of duodenal folds and nodularity, indicating celiac disease changes. A colonoscopy examination was performed, which revealed multiple linear longitudinal ulcerations, friability, erosions and absent vascularity, which indicates Crohn’s disease. Duodenal biopsy shows celiac disease (Marsh IIIa), and Colonic biopsy shows Crohn’s disease. The patient was treated with improvement in abdominal pain, weight, and anemia. Conclusion: Celiac and Crohn’s both conditions are clinically symptomatic in the same patient, as proved by endoscopic and histopathological changes.