Abstract

CASTILLO RAMIREZ, Rogelio Edgar; VILLANUEVA REZA, Marco; MARTINEZ CASTANEDA, Erika Adriana  and  VIDAL TAMAYO RAMIREZ, Rafael. Symptomatic hypocalcemia as a rare celiac disease manifestation in adulthood. A case presetation and literature review. Rev. Fac. Med. (Méx.) [online]. 2018, vol.61, n.5, pp.14-20. ISSN 2448-4865.

Celiac disease (CD) is a systemic process with an immunological basis characterized by gluten intolerance. The worldwide prevalence that has been reported is of approximately 1%. The diagnosis depends on the symptomatology, serological tests and the results of a small bowel biopsy. The typical clinical presentation is characterized by diarrhea, malabsorption and weight loss. Reports describe that the celiac disease is typically found in childhood, however, its diagnosis in adulthood has become a lot more common. A transition exists in the presentation of this nosological entity, from patients with typical symptoms to patients with an asymptomatic type. The identification of the latter has been possible with the detection of serum antibodies and the findings of bowel biopsies performed for other reasons. We present the case of a 57-year old male patient who arrived to the emergency room due to gastrointestinal and neuropathic symptoms. The physical examination highlighted the presence of Chvostek and Trousseau signs. General laboratory studies were requested, and hypocalcemia was identified; hence, a treatment with intravenous calcium infusion was required. The approach was complemented with other studies that suggested malabsorption. A panendoscopy and a colonoscopy with biopsies were performed. The findings suggested a Marsh 3B celiac disease. Finally, antitransglutaminase antibodies were requested and were reported as positive; therefore, a celiac disease diagnosis was made. The treatment started with a gluten-free diet, showing a subsecuent improvement.

Keywords : Malabsorption; hypovitaminosis; chronic diarrhea; electrolytic disturbances.

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