Lis Łukasz, Konieczny Andrzej, Jerzak Patryk, Podgórski Paweł, Benc Krzysztof, Hruby Zbigniew
Department of Nephrology, Renal Transplantation and Internal Medicine, Research and Development Center, Provincial Specialist Hospital in Wrocław, Poland.
Arch Clin Cases. 2021 Oct 27;6(2):31-36. doi: 10.22551/2019.23.0602.10151. eCollection 2019.
Celiac disease (CD) is an immune-mediated disease, caused by gluten, occurring in people with genetic predisposition. The course of the disease can vary and includes both intestinal and extra-intestinal manifestations. Many patients are undiagnosed for many years and some of them, in particular with nonspecific symptoms or asymptomatic, might never be diagnosed. We present a rare case of a patient, who's first and practically the only symptom of the disease was a pathological fracture of the ribs. In addition, despite the lack of clinical symptoms of malabsorption syndrome, malnutrition and proteinuria, we observed profound hypoalbuminemia and hypoproteinemia. This case suggests that CD diagnostic should be undertaken in evaluation of every patient with osteoporotic fractures and hypoalbuminemia.
乳糜泻（CD）是一种由麸质引起的免疫介导性疾病，发生于有遗传易感性的人群中。该病病程各异，包括肠道和肠道外表现。许多患者多年未被诊断，其中一些患者，尤其是有非特异性症状或无症状的患者，可能永远无法被诊断。我们报告一例罕见病例，该患者疾病的首个且几乎是唯一症状是肋骨病理性骨折。此外，尽管缺乏吸收不良综合征、营养不良和蛋白尿的临床症状，但我们观察到严重的低白蛋白血症和低蛋白血症。该病例提示，对于每一位患有骨质疏松性骨折和低白蛋白血症的患者进行评估时都应考虑乳糜泻的诊断。
