Title |
Refractory Celiac Disease Type II: A Case Report that Demonstrates the Diagnostic and Therapeutic Challenges
|
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Published in |
GE-Portuguese Journal of Gastroenterology, September 2015
|
DOI | 10.1016/j.jpge.2015.08.001 |
Pubmed ID | |
Authors |
Alexandra Fernandes, Ana Margarida Ferreira, Rosa Ferreira, Sofia Mendes, Cláudia Agostinho, Nuno Almeida, Pedro Figueiredo, Manuela Ferreira, Pedro Amaro, Lígia Prado e Castro, Carlos Sofia |
Abstract |
Refractory celiac disease is an uncommon but serious complication of celiac disease. We describe a case of a severe refractory celiac disease type II, complicated with ulcerative jejunoileitis, in a 68 years old female, unresponsive to consecutive treatments with budesonide, prednisolone, cladribine and autologous stem cell transplantation. The patient maintained severe malnutrition, advanced osteoporosis, anaemia, vitamin deficiencies and hydro-electrolytic imbalances, necessitating consecutive hospitalizations for total parenteral nutrition. The patient also developed life-threatening complications, namely respiratory and urinary septic shock and also episodes of haemorrhagic shock secondary to ulcerative jejunoileitis. The progression to enteropathy associated T-cell lymphoma was never demonstrated, but the patient died 7 years after the diagnosis due to a septic shock secondary to a nosocomial pneumonia and osteomyelitis related to a spontaneous hip fracture. This case highlights the difficulties in the diagnostic process, therapeutic management and surveillance of this rare condition associated with very poor prognosis. |
X Demographics
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Unknown | 1 | 100% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 1 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 23 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Bachelor | 5 | 22% |
Student > Master | 4 | 17% |
Lecturer | 2 | 9% |
Other | 2 | 9% |
Student > Ph. D. Student | 2 | 9% |
Other | 4 | 17% |
Unknown | 4 | 17% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 5 | 22% |
Nursing and Health Professions | 4 | 17% |
Agricultural and Biological Sciences | 2 | 9% |
Biochemistry, Genetics and Molecular Biology | 2 | 9% |
Veterinary Science and Veterinary Medicine | 1 | 4% |
Other | 5 | 22% |
Unknown | 4 | 17% |