A clinical case of late manifestation of celiac disease concurrent with another autoimmune disease
- Authors: Grinevich V.B.1, Kravchuk Y.A.1, Ivanyuk E.S.1, Seliverstov P.V.1, Yarovenko I.I.1, Karagodin I.S.1, Borisova A.I.1
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Affiliations:
- S.M. Kirov Military Medical Academy, Ministry of Defense of Russia
- Issue: Vol 34, No 5 (2023)
- Pages: 60-64
- Section: From Practice
- URL: https://journals.rcsi.science/0236-3054/article/view/143068
- DOI: https://doi.org/10.29296/25877305-2023-05-10
- ID: 143068
Cite item
Abstract
Celiac disease is a genetically determined disease with its onset in childhood.
In November 2021, a 51-year-old female patient was admitted to the Gastroenterology Department with complaints with diarrhea 5 times daily and severe protein-energy malnutrition by the type of senile kwashiorkor. Analysis of her history indicated that in March 2021, the patient took amoxicilline 500 mg twice daily, as prescribed by the local therapist, for 2 weeks, whereupon she noted the appearance of diarrhea that lasted for a month. Moreover, antibiotic-associated diarrhea was ruled out. A celiac-disease-specific histological pattern of the small bowel mucosa was revealed (the ratio of villus height to crypt depth was 1:1), as well as the titer of antibodies to recombinant tissue transglutaminase-2 IgA class >210 U/ml. This could establish a diagnosis of symptomatic celiac disease. During the gluten-free diet, the stool returned to normal; the body weight gradually began to increase. The persistent severe condition in the patient, hypokalemia, skin bronze hue, low aldosterone levels could diagnose primary hypoaldosteronism. Liver biopsy could diagnose small duct primary sclerosing cholangitis. Thus, it is important to note that the onset of celiac disease may occur may occur in people over 50 years of age; whereas primary hypoaldosteronism and primary sclerosing cholangitis may be associated with celiac disease and have a common autoimmune origin.
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##article.viewOnOriginalSite##About the authors
V. B. Grinevich
S.M. Kirov Military Medical Academy, Ministry of Defense of Russia
Email: seliverstov-pv@yandex.ru
ORCID iD: 0000-0002-1095-8787
Doctor of Medical Sciences, Professor
Russian Federation, Saint PetersburgYu. A. Kravchuk
S.M. Kirov Military Medical Academy, Ministry of Defense of Russia
Email: seliverstov-pv@yandex.ru
ORCID iD: 0000-0001-8347-0531
Doctor of Medical Sciences
Russian Federation, Saint PetersburgE. S. Ivanyuk
S.M. Kirov Military Medical Academy, Ministry of Defense of Russia
Email: seliverstov-pv@yandex.ru
ORCID iD: 0000-0002-2785-6699
Candidate of Medical Sciences
Russian Federation, Saint PetersburgP. V. Seliverstov
S.M. Kirov Military Medical Academy, Ministry of Defense of Russia
Author for correspondence.
Email: seliverstov-pv@yandex.ru
ORCID iD: 0000-0001-5623-4226
Candidate of Medical Sciences
Russian Federation, Saint PetersburgI. I. Yarovenko
S.M. Kirov Military Medical Academy, Ministry of Defense of Russia
Email: seliverstov-pv@yandex.ru
Candidate of Medical Sciences, Associate Professor
Russian Federation, Saint PetersburgI. S. Karagodin
S.M. Kirov Military Medical Academy, Ministry of Defense of Russia
Email: seliverstov-pv@yandex.ru
ORCID iD: 0000-0002-1108-7581
Russian Federation, Saint Petersburg
A. I. Borisova
S.M. Kirov Military Medical Academy, Ministry of Defense of Russia
Email: seliverstov-pv@yandex.ru
ORCID iD: 0000-0001-7234-7968
Russian Federation, Saint Petersburg
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