The Turkish Journal of Pediatrics 2022 , Vol 64 , Num 6
Celiac crisis with thrombocytopenia and coagulopathy in a child
Duygu İskender Mazman 1 ,Selim Dereci 1 ,Şamil Hızlı 2 ,Hayriye Tatlı Doğan 3 ,Burcu Berberoğlu Ateş 1 ,Gülin Hızal 1 ,Arzu Meltem Demir 1 ,Aysel Ünlüsoy Aksu 1
1 Department of Pediatric Gastroenterology, University of Health Sciences, Ankara City Hospital, Ankara
2 Departments of Pediatric Gastroenterology, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Türkiye
3 Departments of Pathology, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Türkiye
DOI : 10.24953/turkjped.2022.216 Background. Celiac disease rarely presents with edema, hypoalbuminemia, acute metabolic deterioration, and electrolyte imbalances. This life-threatening condition is defined as a celiac crisis and may mimic disorders with metabolic derangement and sepsis. The crisis may present at onset or develop in celiac disease patients with poor compliance to a gluten-free diet. The fluid resuscitation and replacement of electrolyte deficits are life-saving modalities.

Case. A 14-month-old girl was admitted with fever, lethargy, severe dehydration, edema, hypotension, and commenced sepsis therapy. However, the patient had a growth delay and loss of weight with diarrhea and delayed motor skills. On admission, laboratory evaluation showed anemia, coagulopathy, hypoalbuminemia, electrolyte disturbances, and metabolic acidosis and developed thrombocytopenia during follow-up. The celiac serological tests and upper gastrointestinal endoscopic duodenal mucosa appearance, and duodenum histopathology findings suggested celiac disease.

Conclusions. This case highlights that a celiac patient may present with a severe illness like sepsis and may be associated with cytopenia and coagulopathy in the celiac crisis. Keywords : celiac crisis, thrombocytopenia, coagulopathy

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