Section of Gastroenterology, Department of Pediatrics, Yale University, New Haven, CT, USA.
J Clin Gastroenterol. 2013 Feb;47(2):127-9. doi: 10.1097/MCG.0b013e318250e468.
Celiac disease and inflammatory bowel disease including ulcerative colitis (UC) and Crohn's disease are both immune-mediated enteropathies. It is rare for both celiac disease and inflammatory bowel disease to occur together in an individual patient. This association has been reported in adults, however, very rarely in children. Here, we report an unusual case of an 8-year-old child with a history of anemia and failure to thrive who presented with bloody diarrhea. His evaluation showed anemia, elevated inflammatory markers, and positive celiac antibodies. Endoscopic evaluation revealed partial duodenal villous atrophy and pancolitis. He was diagnosed with celiac disease and UC and responded well to a gluten-free diet and steroid/mesalamine therapy. The patient's genetic testing revealed markers showing susceptibility for both celiac disease and UC. It is important to be aware of this association as both conditions can present with similar clinical features, however, require different therapeutic approaches.
乳糜泻和炎症性肠病(包括溃疡性结肠炎(UC)和克罗恩病)都是免疫介导的肠病。在一个患者中同时发生乳糜泻和炎症性肠病非常罕见。这种关联在成人中已有报道,但在儿童中非常罕见。在这里,我们报告了一例不寻常的 8 岁儿童病例,该患儿有贫血和生长不良病史,表现为血性腹泻。他的评估显示贫血、炎症标志物升高和乳糜泻抗体阳性。内镜检查显示部分十二指肠绒毛萎缩和全结肠炎。他被诊断为乳糜泻和 UC,对无麸质饮食和类固醇/美沙拉嗪治疗反应良好。患者的基因检测显示出对乳糜泻和 UC 的易感性标志物。重要的是要意识到这种关联,因为这两种疾病都可能表现出相似的临床特征,但需要不同的治疗方法。