Ailevi Akdeniz Ateşi Ön Tanısıyla İzlenen Bir Hastada Çölyak Hastalığı

Abstract

Celiac Disease in a Patient who was Followed as Familial Mediterranian Fever Celiac disease is an enteropathy that goes with small mtestlne mucosal damage in a sensitive person consuming gluten-containing diet. The disease has a wide spectrum of symptoms. In general it presents with chronic diarrhea, abdominal pain, fatigue, weakness, abdominal distention and failure to thrive but patients may refer with a single symptom. Familial Mediterranean Fever (FMF) is a disease that causes chronic abdominal pain. A 13 year-old patient who was suffering from chronic abdominal pain is reported here. At first he was diagnosed as FMF and colchicine treatment was started. Later on, due to treatment failure he was evaluated again and celiac disease was investigated because short stature was noticed in addition to abdominal pain. As the serologic and histopathologic findings supported celiac disease, gluten free diet was started. The symptoms disappeared completely after the gluten free diet. Six months later the patient gained weight and height and the measured serum celiac antibodies became negative. In conclusion, celiac disease should be kept in mind in patients with chronic abdominal pain. Colyak hastaligi, glutenli diyetle beslenen duyarli bireylerde ince barsak mukozasi hasarina yol acan bir enteropatidir. Hastaligin semptom spektrumu oldukca genistir. Genellikle kronik ishal, karin agrisi, istahsizlik, halsizlik, karin sisligi ve buyume geriligi gibi bulgular gorulmekle birlikte hastalar bazen bu bulgularin herhangi biri ile basvurmaktadir. Ailevi Akdeniz Atesi (FMF) kronik karin agrisi ile seyreden hastaliklardan biridir. Bu calismada kronik karin agrisi yalanmasi nedeniyle basvuran ve baslangicta FMF tanisi alan 13 yasinda bir erkek hasta sunduk. Hastada baslangicta FMF dusunulerek kolsisin baslanmis. Tedaviye yanit alinamayinca hasta tekrar degerlendirilmis ve karin agrisi yanisira boy kisaligi bulgusu da olunca colyak hastaligi arastirilmistir. Serolojik ve histopatolojik bulgularla colyak tanisi alan hastada glutensiz diyet baslandiktan sonra kann agrisi sikayeti tamamen kaybolmustur. Alti aylik glutensiz diyet sonrasi yapilan degerlendirmede agirlik ve boy artisi saptanmis ve colyak antikorlari negatiflesmistir. Sonuc olarak kronik karin agrili hastalarda colyak hastaligi unutulmamalidir.