Crisi celiaca: una complicanza rara e insidiosa della celiachia

Coeliac Crisis is an urgent and potentially fatal complication of Coeliac Disease (CeD), which is most frequent in early childhood. The crisis may occur at onset or develop in CeD patients with poor compliance to the gluten-free diet (GFD). Stress, surgery and infections can act as triggers. The diagnosis is based on the acute onset of rapidly progressive diarrhoea associated with at least two conditions among severe dehydration, metabolic acidosis, dyselectrolytemia, renal dysfunction, neurological alterations, hypoproteinemia and weight loss. Haematological manifestations, such as thrombocytopenia, increased INR, aplastic anaemia and leukopenia, are rare. The cornerstones of therapy are intravenous rehydration, correction of hypoalbuminemia, acidosis and dyshionemia along with a strict GFD. Steroids may be also used in refractory cases. The paper describes a recent case of a patient presenting with a severe life-threatening coeliac crisis characterized by inability to walk due to lower limb weakness, severe abdominal distension, diarrhoea and peripheral oedema.