Meena Durga S, Kumar Deepak, Bohra Gopal K, Choudhary Sahadev
Department of Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
J Family Med Prim Care. 2020 Feb 28;9(2):1206-1208. doi: 10.4103/jfmpc.jfmpc_1116_19. eCollection 2020 Feb.
The clinical presentation of celiac disease has evolved significantly over the last few decades. Previously defined as a malabsorption syndrome in pediatric patients, now it is considered an autoimmune disorder with diverse systemic manifestations among all age groups. We report a case of 56-year-old male presented with pedal edema and gradually progressive abdomen distention for the last 3 months. Serological evaluation and duodenal biopsy reports were suggestive of celiac disease. The patient was advised gluten-free diet, after 12 weeks, the patient became asymptomatic with the resolution of ascites and peripheral edema. According to the literature, there are few reports of protein-losing enteropathy as an initial presentation of celiac disease. The possibility of celiac disease should be considered even in the setting of atypical symptoms.
在过去几十年中，乳糜泻的临床表现有了显著变化。以前被定义为儿科患者的吸收不良综合征，现在它被认为是一种自身免疫性疾病，在所有年龄组中都有多种全身表现。我们报告一例56岁男性患者，在过去3个月中出现足部水肿并逐渐进展为腹部膨隆。血清学评估和十二指肠活检报告提示为乳糜泻。建议患者采用无麸质饮食，12周后，患者腹水和外周水肿消退，症状消失。根据文献，很少有关于蛋白丢失性肠病作为乳糜泻初始表现的报道。即使在非典型症状的情况下，也应考虑乳糜泻的可能性。
