A Case of Unrecognized Complicated Celiac Disease

Background

Celiac disease (CD) is a genetic autoimmune disease in which affected individuals are unable to tolerate foods containing gluten, a specific protein of wheat, barley, and other cereals. The abnormal immune response in the intestine triggered by gluten generates a chronic inflammation and results in tissue damage to the small intestine, with the disappearance of the intestinal villi. If CD is not promptly diagnosed and treated, important and, in some cases, irreversible complications may occur [1]. In the most severe manifestations, CD can promote tumor development in the small bowel, such as intestinal lymphoma or adenocarcinoma. Especially in the initial phase of CD, the differential diagnosis will include lymphoma and other diseases [2]. Since the symptoms and endoscopic picture may be similar and non-specific, the diagnosis of CD is often challenging.