Early Celiac Disease in a Soldier Presenting With Marked Weight Loss

Abstract

Introduction: Celiac disease is an immune mediated enteropathy of small intestine triggered by gluten containing diet in genetically susceptible individuals. Early diagnosis in strongly suspected patients presenting with gastrointestinal symptoms, weight loss and malabsorption can be done with the help of serological tests followed by duodenal biopsy from the lower duodenum as gold standard for the definitive diagnosis. Gluten free diet will lead to rapid improvement in clinical symptoms and in nutritional and hematological parameters. These subjects need prolonged follow up to assess adherence to gluten free diet and assess long term consequences of celiac disease. Case Report: 47 years old soldier presented with marked weight loss with chronic diarrhea and malabsorption.Serological tests for celiac disease based on strong clinical suspicion was carried out and immunoglobin A for endomysial antibody was found positive in low titres.On histopathological examination of duodenal biopsy specimens features of early celiac disease was found. Hematological investigations revealed pancytopenia.With gluten free diet individual improved symptomatically in three months with weight gain and normal bowel movement along with improvement in the hematological parameters. Conclusion: Celiac disease need to be kept in differential diagnosis of patients presenting with weight loss,chronic diarrhea and malabsorption.Early diagnosis of celiac disease with serology and duodenal biopsy histopathological examination will benefit the patient by recommending gluten free diet to improve the quality of life and prevent long term consequences of the disease.