An Unusual Case of Chronic Abdominal Pain: Association of Celiac Disease and Crohn's Disease
Inflammatory bowel disease (IBD) and celiac disease (CeD) are immunogenic gastrointestinal diseases whose etiology is not fully understood. Both diseases exhibit a multifactorial origin involving complex interactions between genetic, environmental factors, and several components of the symbiotic microbiota. The coexistence of celiac disease and Crohn's disease is seldom reported in the literature. Here, we report the case of a 13-year-old Syrian male who presented with a history of abdominal pain, anorexia, and pallor; CeD and Crohn's disease were documented by gastrointestinal endoscopy and histological studies. The patient was treated with a gluten-free, low-fiber, high-calorie diet and a course of oral corticosteroids with improvement in growth rate and abdominal pain.
Leen Jamel Doya, Maria Naamah, Noura Karkamaz, Narmin Hajo, Fareeda Wasfy Bijow, Ali Ibrahim, Rana Issa, An unusual case of chronic abdominal pain: association of celiac disease and Crohn's disease, Oxford Medical Case Reports, Volume 2021, Issue 4, April 2021, omab008, https: //doi.org/10.1093/omcr/omab008
Commentary
Celiac disease (CeD) is an inherited chronic inflammatory disease of the small intestine. The incidence of celiac disease is estimated to be about 1% of the world's population, and its etiology is defined by the presence of three factors: one is described as genetic alterations, the second as exposure to gluten, and the third as altered immune response.
It is associated with other autoimmune diseases such as autoimmune thyroiditis, type I diabetes, Addison's disease, primary biliary cirrhosis, and inflammatory bowel disease (IBD), and the prevalence of IBD in CeD is estimated to be 1-3.2%.
The prevalence of IBD in CeD is estimated to be 1~3.2%. Therefore, the coexistence of CeD and CD in this pediatric patient is very rare, and as far as the researchers know, there are less than 30 cases of CeD with CD.
