Pawłowska-Kamieniak Agnieszka, Krawiec Paulina, Pac-Kożuchowska Elżbieta, Mroczkowska-Juchkiewcz Agnieszka, Kominek Katarzyna
Department of Paediatrics, Medical University of Lublin.
Pol Merkur Lekarski. 2016 Jan;40(235):21-4.
Coeliac disease is a chronic immune-mediated inflammation of the small intestine elicited by the gluten ingestion in genetically susceptible people. In coeliac patients there is higher incidence of other autoimmune disorders like type 1 diabetes or Hashimoto's thyroiditis. The coexistence of coeliac disease and inflammatory bowel disease is rare. The spectrum of presentation of coeliac disease and inflammatory bowel disease may be similar. However, those disorders require various therapeutic approaches. Thus, early recognition of the overlap between coeliac disease and inflammatory bowel disease is crucial to apply appropriate treatment and to prevent possible complications. We report a case of a 6-year-old boy with a delay in physical and psychomotor development, rickets, severe anaemia and bloody diarrhoea. He was diagnosed with coeliac disease and ulcerative disease. The coexistence of both disorders is extremely rare in childhood. However, ulcerative colitis should be considered in coeliac children on restrictive gluten-free diet with persistent diarrhoea or bleeding from lower gastrointestinal tract. Screening for coeliac disease should be considered in children with ulcerative colitis with impaired physical development and lack of remission despite of proper treatment.
乳糜泻是一种由遗传易感人群摄入麸质引发的小肠慢性免疫介导性炎症。乳糜泻患者患其他自身免疫性疾病(如1型糖尿病或桥本甲状腺炎)的几率更高。乳糜泻与炎症性肠病同时存在的情况较为罕见。乳糜泻和炎症性肠病的临床表现可能相似。然而,这些疾病需要不同的治疗方法。因此,早期识别乳糜泻和炎症性肠病之间的重叠对于采取适当治疗和预防可能的并发症至关重要。我们报告一例6岁男孩,有身体和精神运动发育迟缓、佝偻病、严重贫血和血性腹泻。他被诊断为乳糜泻和溃疡性疾病。这两种疾病在儿童期同时存在极为罕见。然而,对于采用严格无麸质饮食但仍持续腹泻或下消化道出血的乳糜泻儿童,应考虑溃疡性结肠炎的可能。对于身体发育受损且尽管接受了适当治疗仍未缓解的溃疡性结肠炎儿童,应考虑进行乳糜泻筛查。