Abstract
Celiac disease presenting with recurrent pyrexia and lobular panniculitis: a case report and review of literature
Highlights
Classical celiac disease (CCD) is dominated by gastrointestinal (GTI) symptoms while the atypical celiac diseases (ACD) is associated with extra-intestinal symptoms [1]
The extra-intestinal symptoms include various dermatological conditions the most common ones are dermatitis hepetiformis, linear IgA bullous dermatosis (LABD), urticaria, hereditary angioneurotic edema(HAE), leucocytoclastic vasculitis, erythema nodosum (EN), erythema elevatum diutinum (EED), necrolytic migratory erythema (NME), psoriasis, vitiligo disease, dermatomyositis, and oral lichen planus [2]. lobular panniculitis (LP) has not been described in association with celiac disease to the knowledge of the authors we present this case of ACD with an unusual dermatological manifestation so that clinician will consider CD as a possible diagnosis in patients with fever and skin lesions
We present a 27 yrs old woman migrant from India with background history of closed ASD as a child who presented with relapsing high grade fever for about 4 months and transient diarrhea
Summary
Classical celiac disease (CCD) is dominated by gastrointestinal (GTI) symptoms while the atypical celiac diseases (ACD) is associated with extra-intestinal symptoms [1]. We present a 27 yrs old woman migrant from India with background history of closed ASD as a child who presented with relapsing high grade fever for about 4 months and transient diarrhea She had similar febrile episodes associated with mildly tender left forearm indurated lesion about 2 months back while in India which resolved spontaneously and no obvious cause was found despite extensive investigations. In view of the iron deficiency anemia and diarrhea we screened serologically for celiac disease with anti-transglutaminase and deamidated gliadin antibodies both of which were positive She went to have gastroscope and the duodenal biopsy histology revealed subtotal villous atrophy, broad blunted villi with increase intraepithelial lymphocytes consistent with the diagnosis of coeliac disease. She started on gluten free diet and thyroxine was given for the hypothyroidism. Review 5 months post her presentation she has not had any relapse of the fever, diarrhea or skin lesion
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