[Manifestation of adult celiac disease during the puerperium].
The coeliac disease is a T cell mediated autoimmune enteropathy, presents in genetically susceptible person exposed to gluten. It can manifest in any age group but it is becoming more commonly diagnosed in adulthood. Very rarely it manifests during pregnancy or after childbirth, possibly due to hormonal and immunological changes. In authors' case a young female developed severe diarrhoea resulting in malabsorption following both of her pregnancies. On the first presentation the gluten sensitive enteropathy was not diagnosed despite detailed gastroenterological and endocrine workup. Following her first pregnancy she remained free of symptoms for years on a normal diet. After the birth of her second child her symptoms flared up and she was admitted to authors' department. The diagnosis of coeliac disease was confirmed by the histological finding from a small bowel biopsy. The coeliac specific serologic markers were also positive (antibodies to gliadin, endomysium and tissue transglutaminase). Significant improvement was achieved with supportive therapy and gluten-free diet. Despite the fact that authors' patient's symptoms were transient, the diagnosis of latent coeliac disease seems to be evident. Lifelong gluten-free diet is mandatory to prevent the late complications.
Baranya Megyei Kórház, Belgyógyászati és Gasztroenterológiai Osztály, Pécs.
Judit
J
Bajor
Zoltán
Z
Lomb
Béla
B
Anga
Tamás
T
Beró
D000328:Adult; D017668:Age of Onset; D001323:Autoantibodies / Q000097:blood; D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis* / Q000178:diet therapy / Q000276:immunology / Q000473:pathology; D004386:Duodenum / Q000473:pathology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011644:Puerperal Disorders / Q000175:diagnosis* / Q000178:diet therapy / Q000276:immunology / Q000473:pathology
D001323:Autoantibodies