DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20164617

Childhood coeliac disease presenting as hepatitis with an associated aplastic anaemia: a case report and literature review

Jagannathan Krishnasamy

Abstract


Although aplastic anaemia and deranged liver function test are well documented in the adult coeliac literature, this combination is not well recognized in childhood. We report a case of 8 year old girl who presented with jaundice and spontaneous bruising. Initial investigations showed pancytopenia, raised bilirubin and transaminases. On extensive evaluation to look in to the cause of above presentation, she was found to have coeliac disease with aplastic anaemia. She was started on gluten free diet which resolved her liver derangement. The marrow aplasia persisted however, requiring immune therapies.


Keywords


Aplastic anaemia, Coeliac disease, Deranged liver function test, Pancytopaenia

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References


Husby S, Koletzko S, Korponay-Szabo IR, Mearin ML, Phillips A, Shamir R, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition Guidelines for the Diagnosis of Coeliac Disease. JPGN. 2012;54(1):136-60.

Cozzali R, Castellucci G, Carosati E, Dominijanni V, Ferraro L. Changes in pediatric presentation of celiac disease. Digestive and Liver Disease. 2013;45:e281-282.

Guandalini S, Assiri A. Celiac disease: a review. JAMA Pediatr. 2014;168(3):272-8.

Maheshwari A, Nirupam N, Aneja S, Meena R, Chandra J, Kumar P. Association of celiac disease with aplastic anemia. Indian J Pediatr. 2012;79(10):1372-3.

Badyal RK, Sachdeva MUS, Varma N, Thapa BR. A rare association of celiac disease and aplastic anemia: case report of a child and review of literature. Pediatr Develop Pathol. 2014;17(6):470-3.

Grey-Davies E, Hows JM, Marsh JC. Aplastic anaemia in association with coeliac disease: a series of three cases. British J Haematol. 2008;143(2):258-60.

Salmeron G, Patey N, de Latour RP. Celiac disease and aplastic anemia: a specific entity. British J Hematol. 2009;146:113-24.