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A case of sequential development of celiac disease and ulcerative colitis

Nature Clinical Practice Gastroenterology & Hepatology volume 4, pages 463–467 (2007)Cite this article

Abstract

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.

Investigations Physical examination; analysis of full blood count; measurement of serum ferritin, vitamin B12, 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.

Diagnosis Celiac disease and ulcerative colitis.

Management Gluten-free diet, mesalazine and prednisolone.

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Figure 1: Histologic image of a duodenal biopsy sample from the case patient, obtained soon after the initial presentation
Figure 2: Histologic image of a duodenal biopsy sample from the case patient obtained at the patient's second presentation, almost 5 years after the initial presentation
Figure 3: Image obtained from colonoscopy performed after the patient's third presentation, 6.5 years after her initial presentation

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Author notes

  1. Department of Gastroenterology, Altnagelvin Hospital, Londonderry BT47 6SB, Northern Ireland, UK wildickey@aol.com

Authors and Affiliations

  1. W Dickey is a Gastroenterologist at Altnagelvin Hospital, and Visiting Professor in the Faculty of Life and Health Sciences at the University of Ulster, Londonderry, Northern Ireland, UK.,

    William Dickey

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  1. William Dickey
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Competing interests

The author is an unpaid member of the Medical Advisory Council of Coeliac UK.

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Dickey, W. A case of sequential development of celiac disease and ulcerative colitis. Nat Rev Gastroenterol Hepatol 4, 463–467 (2007). https://doi.org/10.1038/ncpgasthep0897

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