Association of Crohn's disease and latent celiac disease: a case report and review of the literature.
BACKGROUND
Crohn's disease is a chronic inflammatory disease of the intestine potentially affecting all parts of the intestine with predilection sites in the terminal ileum and proximal colon. Its prevalence in Western Europe is 20-40/100,000 with equal affection of both sexes and familiar accumulation. Histopathologically, it is characterized by a discontinuous, segmental manifestation and implication of all intestinal layers. Celiac disease, on the other hand, is defined by histologically proven villous atrophy associated with hyperplasia of crypts, lymphocytic infiltration and clinical improvement after a gluten-free diet.


METHODS
We report the case of a 52-year-old man presenting with long-term diarrhea and loss of weight associated with Crohn's disease. After interventional therapy for an unstable coronary artery syndrome and medical therapy for hyperthyroidism, the diarrhea stopped only after maintaining a gluten-free diet. A latent form of celiac disease (clinical symptoms, improvement after gluten-free diet, detection of anti-gliadin IgA antibodies, negative histology) was diagnosed.


CONCLUSIONS
To our knowledge, this is the first report on the association of Crohn's disease and the latent form of celiac disease in the same patient. Whereas in most cases, Crohn's disease develops secondary to a pre-existing celiac disease, in our patient, latent celiac disease was diagnosed years after the onset of and therapy for Crohn's disease.
Schedel
Jörg
J
Department of Internal Medicine I, University Hospital of Regensburg, 93042 Regensburg, Germany. joerg.schedel@klinik.uni-regensburg.de
Rockmann
Felix
F
Bongartz
Tim
T
Woenckhaus
Matthias
M
Schölmerich
Jürgen
J
Kullmann
Frank
F
D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis / Q000178:diet therapy; D003424:Crohn Disease / Q000150:complications* / Q000178:diet therapy; D003967:Diarrhea / Q000209:etiology; D005983:Glutens; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D015431:Weight Loss
D005983:Glutens