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Crisi celiaca in un bambino di 19 mesi: l'importanza di ripetere i test sierologici in caso di forte sospetto clinico
Celiac crisis in a 19-month-old: the importance of repeating testing in cases of high clinical suspicion
Corrado Matteo Di Febo1, Elena Borali2, Barbara Roviglione2, Ivana Rabbone1, Enrico Felici2
1Scuola di Specializzazione in Pediatria, Universitŕ del Piemonte Orientale, Novara
2Pediatria e Pronto Soccorso Pediatrico, AOU “SS Antonio e Biagio e C. Arrigo”, Alessandria
Novembre 2025 - pagg. 601 -603 | DOI: 10.53126/MEB44601
Abstract
Celiac disease (CD) is an autoimmune disorder that may present with non-specific gastrointestinal symptoms. A serious, potentially lethal complication of CD is celiac crisis (CC), marked by severe diarrhoea, vomiting, dehydration and metabolic disorders. CD diagnosis in children relies on serological tests for anti-endomysium IgA antibodies and anti-transglutaminase IgA antibodies. However, false negatives may occur due to age, concomitant use of drugs, or technical errors. The paper reports the case of a 19-month-old child with severe symptoms despite a former negative serological screening. High clinical suspicion led to repeat the test, which confirmed CD. After starting a gluten-free diet, the child improved rapidly, gained weight and normalised bowel movements. This case illustrates the diagnostic challenges of CD and its most serious complication (CC) in young children and emphasises the need for continuing testing when symptoms persist, even with initial negative results. Timely diagnosis is crucial to prevent serious complications and prescribe an appropriate diet.
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