A Rare Association of Silent Celiac Disease, Acute Hepatitis and Aplastic Anemia: Case Report and Review of Literature
2018
Liver abnormalities are common extra-intestinal manifestations of celiac disease (CD). However,
aplastic anemiahad been rarely described in this disorder. Here, we report an exceptional case suggesting a rare association between asymptomatic CD, acute hepatitis and
aplastic anemia: A Nine-year old girl presented with jaundice of 3 weeks duration and
hepatosplenomegalyon physical exam. Investigations revealed an acute
liver disorderwith high serum transaminases levels. Extensive investigations excluded infectious, metabolic and auto immune as cause of
acute liver disease. A celiac disease was diagnosed according to the histological exam of small bowel biopsy. A reversal of hepatic disorder was observed within 2 months after the initiation of Gluten free diet. However, the child developed
aplastic anemia, which dramatically worsened despite immunosuppressive therapy. The etiological assessment of
aplastic anemiawas negative suggesting an association with hepatitis and silent celiac disease that could be explained by a common underlying immune pathological mechanism. Therefore, a screening of CD in acute
liver disorderand AA should been considered by clinicians.
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