Celiac Crisis Presenting as Status Epilepticus and Irreversible Encephalopathy: A Rare Pediatric Case Report

Abstract

Abstract

Celiac disease is a gluten sensitive enteropathy of small bowel characterized by villous atrophy that leads to malabsorption steatorrhea and weight loss. Broad spectrum of disorders specially auto immune is associated with celiac disease ranging from primary biliary cirrhosis, Sjogren’s syndrome to dermatitis herpetiformis. Celiac disease also shows variety of neurological manifestation including ataxia, epilepsy, neuropathy and myelopathy. The cause of tis association is still not cleared.

Celiac crisis is a life-threatening presentation associated with celiac disease leading to electrolyte imbalance. Neurological manifestation of celiac crisis with residual encephalopathy is rare presentation of celiac crisis with apparently no published local data. We are going to document 2.5 years old give case presented to emergency department with status epilepticus and encephalopathy. Patient was in usual state of health prior to illness at home with history of abdominal distension, intermittent diarrhea and failure to thrive. Patient presented to tertiary care at Bahawalpur in emergency with status epilepticus and encephalopathy with probable diagnosis of TBM. And then referred to the Children Hospital and the Institute of Child Health Multan for status epilepticus at emergency department. In the context of this case, it is suggested that celiac crises should be considered in the differentials of seizures and encephalopathy.  

Key words: Attention deficient hyperactive disorder, Celiac disease, Celiac crises, Encephalopathy Glasgow coma scale, Intracranial pressure, Pakistan Pediatric Association, Signs of meningial irritation, Status epilepticus, Tuberculosis meningitis, The children hospital and institute of children health