n 18-year old Female with a History of Collapse – Case Report

Authors: J. Minařík;  M. Skácelová;  P. Horák;  A. Smržová;  L. Faltýnek;  V. Ščudla
Authors‘ workplace: III. interní klinika – nefrologická, revmatologická a endokrinologická, FN a LF UP v Olomouci
Published in: Transfuze Hematol. dnes,18, 2012, No. 2, p. 81-84.
Category: Comprehensive Reports, Original Papers, Case Reports


The aim of this paper is to report a less frequent cause of collapse associated with minimal clinical symptoms in an 18-year old female. Laboratory examinations revealed severe macrocytic anaemia (Hb 35 g/l, MCV 114 fl) with mild alteration of biochemical parameters. The differential diagnosis focused on a possible malabsorption syndrome, which was finally confirmed in the form of celiac disease. Dietary measures as well as substitution therapy lead to rapid normalization of laboratory parameters and an improvement in the patient´s clinical condition. The aim of our paper is to draw attention to less frequent manifestations of celiac disease and to possible pitfalls of routine differential diagnosis of anaemia.

Key words:
macrocytic anaemia, malabsorption syndrome, collapse, celiac disease


1. Kagnoff MF. Celiac disease. A gastrointestinal disease with environmental, genetic, and immunologic components. Gastroenterol Clin North Am 1992; 21: 405–425.

2. Schuppan D. Current concepts of celiac disease pathogenesis. Gastroenterology 2000; 119: 234–242.

3. Fasano A. Where have all the American celiacs gone? Acta Paediatr Suppl 1996; 412: 20-24.

4. Ferguson A, Arranz E, O’Mahony S. Clinical and pathological spectrum of coeliac disease-active, silent, latent, potential. Gut 1993; 34: 150–151.

5. Stenson WF, Newberry R, Lorenz R, et al. Increased prevalence of celiac disease and need for routine screening among patients with osteoporosis. Arch Intern Med 2005; 165: 393–399.

6. Holmes GK. Non-malignant complications of coeliac disease. Acta Paediatr Suppl 1996; 412: 68–75.

7. Rampertab SD, Pooran N, Brar P, et al. Trends in the presentation of celiac disease. Am J Med 2006; 119: 355.e9–14.

8. Collin P, Reunala T, Rasmussen M, et al. High incidence and prevalence of adult coeliac disease. Augmented diagnostic approach. Scand J Gastroenterol 1997; 32: 1129–1133.

9. Schuppan D, Hahn EG. Celiac disease and its link to type 1 diabetes mellitus. J Pediatr Endocrinol Metab 2001; 14 Suppl 1: 597–605.

10. Meini A, Pillan NM, Villanacci V, et al. Prevalence and diagnosis of celiac disease in IgA-deficient children. Ann Allergy Asthma Immunol 1996; 77: 333–336.

11. Gale L, Wimalaratna H, Brotodiharjo A, Duggan JM. Down’s syndrome is strongly associated with coeliac disease. Gut 1997; 40: 492–496.

12. Sainsbury A, Sanders DS, Ford AC. Meta-analysis: Coeliac disease and hypertransaminasaemia. Aliment Pharmacol Ther 2011; 34: 33–40.

13. Counsell CE, Taha A, Ruddell WS. Coeliac disease and autoimmune thyroid disease. Gut 1994; 35: 844-846.

14. Breen EG, Coghlan G, Connolly EC, et al. Increased association of ulcerative colitis and coeliac disease. Ir J Med Sci 1987; 156: 120–121.

Haematology Internal medicine Clinical oncology

Article was published in

Transfusion and Haematology Today

Issue 2

2012 Issue 2

Most read in this issue
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account