Miconi Francesco, Savarese Emanuela, Miconi Giovanni, Cabiati Gabriele, Rapaccini Valentina, Principi Nicola, Esposito Susanna
Paediatric Clinic, Azienda Ospedaliera di Terni, 05100 Terni, Italy.
Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, 20122 Milan, Italy.
Int J Environ Res Public Health. 2017 Jul 29;14(8):855. doi: 10.3390/ijerph14080855.
Celiac disease (CD) is an autoimmune disorder deriving from an aberrant adaptive immune response against gluten-containing grains in genetically predisposed subjects. In a number of patients, CD is associated with one or more other autoimmune diseases. Primary Addison's disease (AD) and CD may co-exist, although this association is relatively uncommon in children. In addition, it is not precisely defined whether a gluten-free diet influences the course of AD.
A case of CD in a 12-year-old boy presenting as acute adrenal insufficiency is described here. A gluten-free diet had a significant therapeutic role in this case, wherein most of the clinical signs and symptoms of AD disappeared in a few days. In addition, the dosage of cortisol acetate, initially administered to treat the AD, was able to be rapidly reduced.
This case highlights that CD can be associated with AD in children, and a gluten-free diet seems to positively influence the course of AD.
乳糜泻（CD）是一种自身免疫性疾病，源于遗传易感性个体针对含麸质谷物的异常适应性免疫反应。在许多患者中，CD与一种或多种其他自身免疫性疾病相关。原发性肾上腺皮质功能减退症（AD）和CD可能共存，尽管这种关联在儿童中相对不常见。此外，无麸质饮食是否会影响AD的病程尚无明确定义。
本文描述了一名12岁男孩以急性肾上腺功能不全为表现的CD病例。无麸质饮食在该病例中具有显著的治疗作用，其中AD的大多数临床体征和症状在几天内消失。此外，最初用于治疗AD的醋酸皮质醇剂量能够迅速减少。
该病例表明，儿童CD可与AD相关，无麸质饮食似乎对AD的病程有积极影响。
