title: Celiac Crisis in Refractory Celiac Disease Type I with Neurological Manifestations: A Diagnostic Dilemma.
abstract: Celiac crisis is a life-threatening condition in which patients have profuse diarrhea and severe metabolic disturbances. Refractory Celiac Disease (RCD) is a rare condition defined as persistence of symptoms despite being on Gluten Free Diet (GFD) for 6 months. Neurological involvement in Celiac Disease (CD) is seen in around 8 - 10% of adult patients; however, it is rare in children. Herein we present a case of an adolescent presenting with neurological symptoms and celiac crisis and diagnosed as RCD, type 1. He was treated with high dose steroids. This case underscores the need to consider RCD in patients presenting in celiac crisis and showing no improvement on GFD.
authors.affiliation: Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
authors.forename: Ayesha Aslam
authors.initials: AA
authors.lastname: Rai
authors.affiliation: Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
authors.forename: Muhammad Osama
authors.initials: MO
authors.lastname: Butt
authors.affiliation: Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
authors.forename: Syed Mudassir
authors.initials: SM
authors.lastname: Laeeq
authors.affiliation: Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
authors.forename: Zaigham
authors.initials: Z
authors.lastname: Abbas
authors.affiliation: Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
authors.forename: Nasir Hasasan
authors.initials: NH
authors.lastname: Luck
authors.affiliation: Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
authors.forename: Syed Mujahid
authors.initials: SM
authors.lastname: Hassan
authors.affiliation: Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
authors.forename: Abbas Ali
authors.initials: AA
authors.lastname: Tasneem
authors.affiliation: Department of Histopathology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Mubarak
mesh_terms: D000293:Adolescent; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis / Q000178:diet therapy* / Q000503:physiopathology; D003967:Diarrhea / Q000175:diagnosis / Q000209:etiology*; D055050:Diet, Gluten-Free; D006801:Humans; D008297:Male; D009422:Nervous System Diseases / Q000150:complications*; D017211:Treatment Failure