Hyperparathyroidism in celiac disease: A case study from UAE

Fayadh Makki H,Awadh Salim,El Kiwisney Loai,Shetty Prasad K,Naguib Mervat,Quadri Abdul Hadi

doi:10.29328/journal.acgh.1001016

Abstract

Celiac disease affects 1% of the world population; however it is under diagnosed in UAE. The disease has many clinical manifestations, ranging from severe malabsorption to minimally symptomatic or non-symptomatic presentation. Hypocalcaemia is a common finding in celiac disease and could be the only presentation of the disease; however hypercalcemia has been previously reported in patients with celiac disease either due to primary hyperparathyroidism or tertiary hyperparathyroidism due to prolonged hypocalcaemia. A normal calcium level on the other hand in patients with untreated celiac disease who also have primary hyperparathyroidism can be due to interplay of these two conditions and may delay the diagnosis of primary Hyperparathyroidism. We report the very first case from our practice in UAE with untreated celiac disease and normal calcium level at presentation, where a diagnosis of primary hyperparathyroidism was not entertained initially. Patient went on gluten free diet which then caused normalization of intestinal abnormalities and likely calcium absorption manifesting as hypercalcemia on subsequent labs. This led to further work up and finally the diagnosis of Primary hyperparathyroidism due to parathyroid adenoma.

Highlights

Celiac disease (CD) is the most common autoimmune disorder induced by gluten ingestion which is found in wheat, oats, rye, barley and other grains
In our experience in Iraq and UAE we came across a variety of presentations of CD ranging from re lux disease, irritable bowel syndrome, anemia, recurrent stomatitis, https://www.heighpubs.org/hcg infertility, elevated liver enzymes, short stature, obesity, association with in lammatory bowel diseases and they missed because of lack of awareness by the health care workers
Hypocalcemia is more common than hypercalcemia in patients with untreated celiac disease

Summary

Introduction

Celiac disease (CD) is the most common autoimmune disorder induced by gluten ingestion which is found in wheat, oats, rye, barley and other grains. How to cite this article: Fayadh MH, Awadh S, El Kiwisney L, Quadri AH, Shetty PK, et al Hyperparathyroidism in celiac disease: A case study from UAE. Many patients with celiac disease present at a later age with subtle symptoms such as diarrhea, unexplained anemia and osteoporosis and the diagnosis may be delayed [8].

Results

Conclusion