Association between Celiac Disease and Intussusceptions in Children: Two Case Reports and Literature Review
A 7-year-old boy was admitted due to vomiting, diarrhea, and severe abdominal pain since three days ago. His vital signs were stable. In physical examination, he was ill, pale with normal heart and lung. His weight and height were 17 kg (<5% weight percentile for age for boys) and 116 cm (10% height percentile for age). Abdominal examination showed distention, bowel sounds were hyperactive and palpation was painful and tender diffusely without palpable mass. Abdominal ultrasonography was done due to sustained abdominal pain and revealed an intussuscepted bowel segment with pseudo-kidney appearance without obstruction (). His intussusception was reducted neither over the time nor by barium enema, so underwent surgical reduction. Intussusception was ileoileal type, with multiple enlarged lymph nodes. In investigation for concomitant failure to thrive, he was anemic (hemoglobin, 10.4 g/dL) and tissue transglutaminase levels (tTG IgA, IgG) were 268 U/mL (normal range, 0-12), and 3.6 U/mL (normal range, 0-1), respectively. Duodenal biopsies were taken and histopathology revealed marsh III celiac disease (). After 6 months gluten free diet (GFD) his weight raised 3 kg and tTg IgA reached to 28 U/mL and tTG IgG to 1 U/mL.