Abstract
In this report, a ten-year-old boy was presented with a history of chronic diarrhea, recurrent wheezing, recurrent respiratory infections, finger clubbing, and growth retardation. Due to bronchiectasis in the chest tomography, low gaita elastase levels, and symptoms and signs of the case, the patient was diagnosed with cystic fibrosis at first. Nevertheless, since the patient’s response to enzyme replacement therapy was poor, sweat test results detected at intermediate levels, and gene analysis of cystic fibrosis-associated mutations were not found. A further evaluation was performed for a differential diagnosis, and Celiac disease was the final diagnosis of the patient. Our paper highlighted that patients with cystic fibrosis symptoms should be evaluated further for Celiac disease, especially in cases resistant to standard cystic fibrosis treatment. Thus, Celiac disease must be kept in mind in differential diagnoses of cystic fibrosis patients resistant to therapy or in conditions in which cystic fibrosis diagnosis is not certain.
References
- 1. Green PH, Cellier C. Celiac disease. N Engl J Med 2007;357:1731- 1743.
- 2. Orenstein DM, Winnie GB, Altman H. Cystic fibrosis: a 2002 update. J Pediatr 2002;140:156-164.
- 3. Kostovski A, Zdraveska N. Coagulopathy as initial manifestation of concomitant celiac disease and cystic fibrosis: a case report. J Med Case Reports 2011;5:116.
- 4. Pohl JF, Judkins J, Meihls S, Lowichik A, Chatfield BA, McDonald CM. Cystic fibrosis and celiac disease: both can occur together. Clin Pediatr (Phila) 2011;50(12):1153-5.
- 5. Haworth CS, Bilton D, Elborn JS. Long-term macrolide maintenance therapy in non-CF bronchiectasis: evidence and questions. Respir Med 2014;108(10):1397-408.
- 6. Fluge G, Olesen HV, Gilljam M, Meyerd P, Presslere T, Storrösten OT et al. Co-morbidity of cystic fibrosis and celiac disease in Scandinavian cystic fibrosis patients. J Cyst Fibros 2009;8:198-202.
- 7. Walkowiak J, Blask-Osipa A, Lisowska A, Oralewska B, Pogorzelski A, Cichy W et al. Cystic fibrosis is a risk factor for celiac disease. Acta Biochim Pol 2010;57:115-118.
- 8. Gheorghe C, Seicean A, Saftoiu A, Tantau M, Dumitru E, Jinga M, et al. Romanian guidelines on the diagnosis and treatment of exocrine pancreatic insufficiency. J Gastrointestin Liver Dis 2015;24(1):117-123.
- 9. Genkova ND, Yankov IV, Bosheva MN, Anavi BL, Grozeva DG, Dzhelepova NG. Cystic fibrosis and celiac disease-multifaceted and similar. Folia Med (Plovdiv) 2013;55(3-4):87-89.
Abstract
Bu yazıda kronik ishal, tekrarlayan hışıltılı solunum atakları, sık solunum yolu enfeksiyonu, parmaklarda çomaklaşma ve büyüme geriliği bulunan 10 yaşında bir olgu sunulmuştur. Vakanın semptom ve bulguları, akciğer tomografisinde bronşiektazi saptanması, düşük dışkı elastaz seviyeleri nedeni ile başlangıçta kistik fiboz tanısı düşünülmüştür. Ancak, hastanın enzim replasman tedavisine yanıtının düşük olması, ter testi sonuçlarının orta düzeyde olması ve gen analizinde kistik fibroz ilişkili mutasyonların saptanmaması nedeniyle ayırıcı tanılar için ileri incelemeler yapılmış ve hastaya Çölyak hastalığı tanısı konmuştur. Makalemizde, özellikle kistik fibroz tedavisine dirençli kistik fibroz bulguları olan hastaların Çölyak hastalığı açısından ileri incelenmesinin gerekliliği vurgulanmıştır. Diğer bir deyişle, Çölyak hastalığı, kesin kistik fibrozis tanısı konulamayan veya enzim replasman tedavisine dirençli kistik fibroz tanılı hastalarda ayırıcı tanıda düşünülmelidir.
Keywords
References
- 1. Green PH, Cellier C. Celiac disease. N Engl J Med 2007;357:1731- 1743.
- 2. Orenstein DM, Winnie GB, Altman H. Cystic fibrosis: a 2002 update. J Pediatr 2002;140:156-164.
- 3. Kostovski A, Zdraveska N. Coagulopathy as initial manifestation of concomitant celiac disease and cystic fibrosis: a case report. J Med Case Reports 2011;5:116.
- 4. Pohl JF, Judkins J, Meihls S, Lowichik A, Chatfield BA, McDonald CM. Cystic fibrosis and celiac disease: both can occur together. Clin Pediatr (Phila) 2011;50(12):1153-5.
- 5. Haworth CS, Bilton D, Elborn JS. Long-term macrolide maintenance therapy in non-CF bronchiectasis: evidence and questions. Respir Med 2014;108(10):1397-408.
- 6. Fluge G, Olesen HV, Gilljam M, Meyerd P, Presslere T, Storrösten OT et al. Co-morbidity of cystic fibrosis and celiac disease in Scandinavian cystic fibrosis patients. J Cyst Fibros 2009;8:198-202.
- 7. Walkowiak J, Blask-Osipa A, Lisowska A, Oralewska B, Pogorzelski A, Cichy W et al. Cystic fibrosis is a risk factor for celiac disease. Acta Biochim Pol 2010;57:115-118.
- 8. Gheorghe C, Seicean A, Saftoiu A, Tantau M, Dumitru E, Jinga M, et al. Romanian guidelines on the diagnosis and treatment of exocrine pancreatic insufficiency. J Gastrointestin Liver Dis 2015;24(1):117-123.
- 9. Genkova ND, Yankov IV, Bosheva MN, Anavi BL, Grozeva DG, Dzhelepova NG. Cystic fibrosis and celiac disease-multifaceted and similar. Folia Med (Plovdiv) 2013;55(3-4):87-89.
Details
| Primary Language | English |
|---|---|
| Subjects | Paediatrics |
| Journal Section | Case Report |
| Authors | |
| Publication Date | May 17, 2021 |
| Published in Issue | Year 2021 Volume: 21 Issue: 1 |
