title: Coexistence of Celiac and Crohn's Disease in a Patient Presenting with Chronic Diarrhea.
abstract: Celiac disease (CD) is one of the most common causes of malabsorption. It is an immune-mediated disease manifested by diarrhea, steatorrhea, flatulence, and weight loss, caused by ingestion of gluten containing diets. The disease has typical small intestinal biopsy features of villous atrophy, crypt hyperplasia, and intense inflammation of the mucosal layer. The disease is rarely associated with Crohn's disease (CRD). Studies on the impact of CD on the natural history of inflammatory bowel disease (IBD) have shown that the natural course of CRD is not influenced by coexistent CD. We report a case of 54-year female who presented with diarrhea and weight loss. On initial evaluation, CD was diagnosed, and responded to gluten-free diet (GFD). Later on, she developed joint pains and her diarrhea recurred. Further evaluation revealed coexistence of CRD. The treatment of CRD was also initiated and this led to marked improvement in the symptoms of the patient.
authors.affiliation: Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
authors.forename: Ghulamullah
authors.initials: G
authors.lastname: Lail
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 Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
authors.forename: Muhammed Osama
authors.initials: MO
authors.lastname: Butt
authors.affiliation: Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
authors.forename: Nasir Hassan
authors.initials: NH
authors.lastname: Luck
authors.affiliation: Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
authors.forename: Syed Mudassir
authors.initials: SM
authors.lastname: Laeq
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 Pathology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
authors.forename: Muhammed
authors.initials: M
authors.lastname: Mubarak
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis* / Q000178:diet therapy; D003113:Colonoscopy; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D003967:Diarrhea / Q000209:etiology*; D055050:Diet, Gluten-Free; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D001379:Azathioprine