Gökhan DİNDAR, Melis BEKTAŞ, Mesut SEZİKLİ

Hiperbiluribinemi ile Seyreden Çölyak Hastalığı

Çölyak hastalığı gluten içeren gıdaların alımıyla tetiklenen otoimmun bir bozukluktur. Farklı klinik tablolar oluşturabilir (1).Çoğunlukla çocukluk çağında tipik bulgularla tanı almasına rağmen erişkin yaşta da çok farklı klinik tablolar ile gelebilir. Tipik bulguları karında şişkinlik,glutenli gıda yemek sonrası diyare atakları,kilo alamama iken hastalar atipik olarak eklem ağrısı,demir eksikliği anemisi,nedeni bilinmeyen karaciğer hasarı,kadınlarda abortus ve infertilite gibi bulgular ile gelebilir. ÇH toplumdaki sıklığı %1-2 civarındadır (2). IVF tedavisi sonrası asit, sarılık ve genel durum bozukluğu gelişen ve çölyak hastalığı tanısı konan bir olgu sunulmuştur.

Severe Hyperbilurinemia and Coeliac Disease

Celiac disease is an autoimmune disorder triggered by the intake of foods containing gluten. It can create different clinic tables. Although it is usually diagnosed with typical findings in childhood, it may come with very different clinical tables in adulthood. While bloating, diarrhea after gluten intake and inability to gain weight are its typical findings, patient can admit with its atypical findings as joint pain, ıron deficiency anemia, abnormal liver function test, infertility and abortus in women. It's prevalance is about 1-2 %. We present a case who was taken diagnosis of celiac disease when presented with ascites, icterus and general statement disorientation after IVF treatment.

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1. Green PH, Cellier C. Celiac disease. N Engl J Med 2007; 357:1731-43.
2. NIH Consensus Development Conference on Celiac Disease. NIH Consens State Sci Statements 2004; 21:1- 23.
3. Bardella MT, Vecchi M, Conte D, et al. Chronic unexplained hypertransaminasemia may be caused by occult celiac disease. Hepatology 1999; 29:654-7.
4. Poddar U. Pediatric and adult celiac disease: similarities and differences. Indian J Gastroenterol. 2013; 32:283-8.
5. Tan SL.,Balen A., el-Hussein E., et al. The administration of glucocorticoids for the prevention of ovarian hlperstimulation slndrome in in vitro fertilization: a prospective randomized study. FertilSteril . 1992; 58:378-83
6. Pablo Olivera, Juan Lasa. Celiac Disease and the Risk of Infertility. İnternational Journal of Celiac Disease, 2015; 3; 84-6.
7. Morris JS, Adjukiewicz AB, Read AE. Coeliac infertility: an indication for dietary gluten restriction? Lancet 1970; 1: 213-4.
8. Collin P,Vilska S,Heinonen S.P et al. Infertility and coeliac disease. Gut 1996; 39: 382-4
9. Bakhshipour A, Kaykhaei MA, Moulaei N et al.Prevalence of coeliac disease in patients with non-alcoholic fatty liver disease. Arab J Gastroenterol. 2013; 14:113-5.
10. Demir H, Yüce A, Çağlar M, et al. Cirrhosis in children with celiac disease. J Clin Gastroenterol 2005; 39:630-3.
11. Hagander B, Berg NO, Brandt L, et al. Hepatic injury in adult coeliac disease. Lancet 1977; 2: 270-2
12. Mones RL, Atienza KV, Youssef NN, et al. Celiac crisis in the modern era. J Pediatr Gastroenterol Nutr 2007; 45:480-3.
13. Jamma S, Rubio-Tapia A, Kelly CP, et al. Celiac crisis is a rare but serious complication of celiac disease in adults. Clin Gastroenterol Hepatol 2010; 8:587-90.
14. Bhattacharya M, Kapoor S. Quadriplegia due to celiac crisis with hypokalemia as initial presentation of celiac disease: A case report. J Trop Pediatr 2012; 58:74-6.
15. Kenrick K, Day AS. Coeliac disease: Where are we in 2014? Aust Fam Physician 2014; 43:674- 8.
16. Baranwal AK, Singhi SC, Thapa BR, Kakkar N. Celiac crisis. Indian J Pediatr. 2003;70:433-5.
17. Novacek G, Miehsler W, Wrba F, et al. Prevalance and clinical importance of hypertransaminasaemia in coeliac disease. Eur J Gastroenterol Hepatol 1999; 11:283-8.
18. Arslan N, Büyükgebiz B, Öztürk Y, et al. The prevalance of liver function abnormalities in pediatric celiac disease patients and its relation with intestinal biopsy findings. Acta Gastroenterol Belg 2005; 68:424-7