Puerperium and Celiac Disease: How to Explain this Association

Abstract

1.1. Introduction: Celiac disease (CD) is defined as an immune-mediated disease consequent to the sensitivity to gluten ingestion and related proteins in genetically predisposed individuals. 1.2. Objective: Report the case of a young patient with CD during puerperium with a previous history of abortion. 1.3. Method: Data were collected in clinical history, physical examination and medical records, in addition to conclusive tests for a diagnostic definition. 1.4. Case report: A female patient presented chronic diarrhea from the 15th day after delivery for five months. It progressed to weight loss and vomiting. She was diagnosed with CD through serologic test and biopsy of the duodenum and terminal ileum. 1.5. Discussion: The exposure to gluten results in inflammatory injuries of the intestinal mucosa, triggering atrophy of the villi and malabsorption syndrome. Some patients develop a latent form of CD, which was the case of this study’s patient, whose disease was developed in early pregnancy and was activated in the puerperium. Pregnancy is a significant factor in the unmasking of latent CD. CD is also associated with gynecological and obstetric disorders and the failure to recognize the disease has been associated with a worse outcome for the fetus. 1.6. Conclusion: Thus, it is important to list the undiagnosed CD as a relevant factor to preconception counseling under the title of unrecognized or pre-existing medical conditions. This case and others suggest that pregnancy and Puerperium should be added to the list of CD trigger factors.