Celiac Disease Associated with Aplastic Anemia in a 6-Year-Old Girl

Celiac.com 03/07/2018 - People with celiac disease can sometimes have hematological issues, including chronic anemia. It might be surprising to hear, but aplastic anemia and celiac disease share a similar underlying autoimmune process, but doctors haven't reported many cases that indicate that the two are connected. In fact, medical literature reveals only three pediatric cases indicating a connection. Recently, clinicians reported the first case in a female pediatric patient.

The clinical team included Omar Irfan, Sana Mahmood, Heera Nand, and Gaffar Billoo, with the Medical College and the Department of Pediatrics at Aga Khan University Hospital in Karachi, Pakistan. Their team treated a 6-year-old South Asian girl who had bruises, petechiae, and recent history of loose stools. On evaluation, the team diagnosed the girl to have celiac disease and prescribed a gluten-free diet. Follow-up assessment including bone marrow biopsy showed the girl to have pancytopenia.

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The team managed the girl's condition with packed red cells, platelets, and diet restrictions, and the girl showed improving platelet counts over yearly follow up visits. Eventually, the girl will need a bone marrow transplant, and the team spoke about that to the girl's parents.

This is now the fourth report indicating a connection between celiac disease and aplastic anemia in children, and the clinical team wonders if the connection might be more common than is currently understood.

Timely treatment of celiac disease through strict gluten-free diet, or aplastic anemia through immunosuppressive therapy, could help reduce the development of other autoimmune conditions.

Because all four pediatric cases reporting potential celiac disease/aplastic anemia association occurred in South East Asia, the authors suggest larger studies to explore this connection.

Source:

• J Med Case Reports. 2018;12(16)