Celiac Crisis in the Postpartum: A Life-Threatening Cause of Diarrhea and Malnutrition.

Abstract

Introduction: Celiac crisis is a rare, severe manifestation of celiac disease, characterized by acute gastrointestinal symptoms, malnutrition, metabolic disturbances, and potential life-threatening complications. Postpartum celiac crisis is particularly rare but can be triggered by the physiological and hormonal changes of the puerperal period.

Case presentation: We report the case of a 42-year-old woman with a 3-month history of watery diarrhea, significant weight loss, extremity paresthesias, muscle spasms, and lower limb edema following childbirth. Initial evaluation revealed severe malnutrition, electrolyte imbalances, and hypoalbuminemia. Endoscopic studies showed significant villous atrophy and mucosal damage, suggestive of celiac disease, which was confirmed by serological and histological findings. The patient was diagnosed with celiac crisis and initiated on a strict gluten-free diet with supportive care, resulting in full clinical and biochemical recovery.

Discussion: This case highlights the importance of considering CD in the differential diagnosis of postpartum malnutrition and chronic diarrhea. Postpartum period may trigger the disease, underscoring the need for awareness in clinical settings. Celiac hepatitis is a prevalent occurrence within the spectrum of CD, with transient transaminase elevation with resolution following the initiation of a gluten-free diet. Celiac crisis, though rare, requires prompt diagnosis and intervention to avoid further complications.