Case presentation:
A 43-year-old woman K.A has history of chronic
anemia. She was treated with iron supplemants for
years, no significant pathological family. She
presented to the Internal Medicine consult with
chronic bloody diarrhea with glairs amounted to
more 5 stools per day, along with an anal fissure and
weight loss appeared two months and moderate
anemia Symptoms
A complete blood count revealed a hypochromic
microcytic anemia ( hemoglobin = 7.4 g/dl, MCV = 75
u3, MCHC = 28%), white cell count of 4200/ mm3 g/dl,
platelets count of 181,000/ mm3, inflammatory
syndrome (VS = 80 mm, CRP= 31 ), and iron
deficiency tests were positive. hepatic and renal
function tests, electrolytes were all normal .
Laboratory studies showed that Anti-tissue
transglutaminase was more than 90 units/ mL.
lower gastrointestinal endoscopy has revealed a
diffuse continuous erythematous lesions limited in
the colon with decreased vascular markings , the
pathologic evaluation has shown non-specific
inflammatory changes , mild active colitis, crypt
architectural abnormalities with loss of goblet cells
and basal plasmacytosis
Upper gastrointestinal endoscopy has found
scalloping images and reduced folds height ,its
pathologic evaluation has shown moderate villous
atrophy and Intraepithelial lymphocytes were
increased greater than 30% which is specific for
celiac disease.
aspect hachuré colonoscopie de RCUH
She was treated by lifelong a gluten-free diet
for celiac disease and corticosteroids / mesalamine
therapy which is essential for managing ulcerative
colitis. In a recent follow-up, bleeding was ceased, no
anemia and weight gain ,the patient remains on our
consult.
Discussion:
The co-occurrence of ulcerative colitis (UC) and
celiac disease (CD) is a recognized phenomenon in
which patients may have both conditions
simultaneously. UC is a chronic IBD that affects the
colon and rectum, while CD is an autoimmune
enteropathy characterized malabsorption due to
villous atrophy of the proximal small intestine
regressing after gluten free diet [1].
The exact mechanisms underlying the co-occurrence
of UC and CD are not fully understood, Such findings
suggests the possibility of similar etiopathogenic
mechanisms involving immunological abnormalities.
but it is believed that both conditions may share
some genetic and environmental risk factors [2,3].
. The existence of familial forms of this association
could evoke a particular genetic predisposition
explains the concomitant occurrence of both
diseases in the same individual [2].
The co-occurrence of UC and CD can present
significant challenges. Both diseases have similar
symptoms, which can make it difficult to distinguish
between them. In fact, the patients often have
common symptoms, such as diarrhea, weight loss
and abdominal pain .This association occurs most
often in the young adult and poses a diagnostic
problem.
.
Conclusion:
the co-occurrence of Ulcerative Colitis and Celiac
Disease is rare, is possible, evoking a particular
genetic background and a similar pathogenesis
conditions and it can present with similar clinical
features, but require different therapeutic
approaches
la 4 ème journée de FMC DE L’AMIE &
LA SOCIÉTÉ ALGÉRIENNE D'OBÉSITÉ ET MALADIES MÉTABOLIQUES
Introduction:
Celiac disease (CD) and inflammatory bowel disease (IBD) including ulcerative colitis (UC) are both immune-
mediated enteropathies but two distinct diseases. UC is a chronic inflammatory bowel disease that affects
the colon and rectum, while CD is an autoimmune disease that affects the small intestine in response to the
ingestion of gluten. It is rare for both to occur together in the literature. We report a new case of
Simultaneous occurrence of Ulcerative Colitis and Celiac Disease was diagnosed at the same time
Keywords: celiac disease(CD) , Inflammatory bowel disease (IBD) ,ulcerative colitis (UC)
References
1-Co-occurrence of celiac disease and ulcerative colitis in an Iranian girl :Mehran Hakimzadeh et al http www.immunopathol.com DOI:10.34172/ipp.2022.xx
2- A Rare Association: Celiac Disease and Ulcerative Colitis Younes Elgamrani Elgamrani et al., J Med Diagn Meth 2016, 5:3 DOI: 10.4172/2168-9784.1000223
3- Simultaneous presentation of coeliac disease and ulcerative colitis in a child. J Paediatr Child Health. 1999;35:204-6. doi:10.1046/j.1440-1754.1999.t011-00328.x.
A rare co-occurrence of Ulcerative Colitis and Celiac
Disease : a case report
D. Merdaci M.Benkaouha D.Azizi
Department of Internal Medicine kais hospital