A case of sequential development of celiac disease and ulcerative colitis.
BACKGROUND
A 65-year-old white female who presented with flatulence and weight loss was investigated by celiac antibody testing, esophagogastroduodenoscopy, duodenal biopsy and colonoscopy. There were no positive findings, except for diverticulosis. Almost 5 years later repeat investigations performed in response to the patient's anemia confirmed the development of celiac disease. After 18 months of symptom improvement as a result of gluten exclusion the patient developed diarrhea, and colonoscopy revealed ulcerative colitis.


METHODS
Physical examination; analysis of full blood count; measurement of serum ferritin, vitamin B(12), folate and C-reactive protein levels; thyroid and autoantibody profiling (including analysis of endomysial and tissue transglutaminase antibodies); CT scanning of the chest, abdomen and pelvis; and performance of esophagogastroduodenoscopy, push enteroscopy, colonoscopy and wireless capsule endoscopy.


METHODS
Celiac disease and ulcerative colitis.


RESULTS
Gluten-free diet, mesalazine and prednisolone.
Department of Gastroenterology, Altnagelvin Hospital, Londonderry, Northern Ireland, UK. wildickey@aol.com
William
W
Dickey
D000368:Aged; D001706:Biopsy; D053704:Capsule Endoscopy; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis; D003093:Colitis, Ulcerative / Q000150:complications* / Q000175:diagnosis; D003113:Colonoscopy; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D006801:Humans