Doença celíaca no adulto e invaginação intestinal - A propósito de um caso clínico

Adult celiac disease and intestinal invagination

 

S. Lopes¹, S. Broco², D. Vieira³, O. Mota³, F. Portela⁴, P. Figueiredo⁴, M. Cipriano⁵, J. Adelino⁶, B. Alexandrino³, J.J. Moura³

 

Resumo

Os autores descrevem o caso de uma doente de 26 anos internada no Serviço de Medicina por sub-oclusão intestinal complicada por pneumonia, anemia normocítica e parâmetros biológicos de inflamação elevados. Esta sintomatologia surgiu num quadro de diarreia crónica e perda ponderal, numa doente com episódios de diarreia na infância, tendo sido questionada a etiologia deste quadro com envolvimento sistémico. O estudo complementar confirmou a hipótese de Doença Celíaca associada à presença de invaginação intestinal complicada por pneumonia. A evolução clínica e laboratorial foi favorável, após antibioterapia e instituição da dieta sem glúten. Os autores destacam a necessidade de rever as várias formas de expressão da doença considerando-a como uma condição frequente mas sub-diagnosticada, podendo condicionar o desenvolvimento de complicações significativas.

Palavras-chave: Doença Celíaca; invaginação intestinal.

 

Abstract

The authors describe a case of a 26 year-old woman admitted to the Medicine Department because of partial intestinal obstruction associated with a pneumonia, inflammatory anaemia and biological parameters of inflammation. This condition happened after chronic diarrhoea and weight loss, referring also episodes of diarrhoea in her childhood. The investigation has confirmed possible celiac disease associated to enteroenteric intussusception complicated with pulmonary infection. The clinical evolution was favourable after antibiotherapy and gluten-free diet. We present this case reflecting the need of reviewing and thinking on the various forms of the disease’s expression, considering it to be a not uncommon condition. Celiac disease is underdiagnosed, and can carry serious damage.

Keywords: Celiac disease; Intussusception.

 

 

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Bibliografia

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Serviço de Medicina II – Hospitais da Universidade de Coimbra;

¹Interna Complementar de Gastrenterologia, Serviço de Gastrenterologia – HUC;

²Interna Complementar de Oncologia – IPOFG – CRC;

³Serviço de Medicina II – HUC;

⁴Serviço de Gastrenterologia – HUC;

⁵Serviço de Anatomia Patológica – HUC;

⁶Serviço de Imagiologia – HUC.

 

Correspondência:

Sandra Maria Fernandes Lopes

Serviço de Gastrenterologia

Hospitais da Universidade de Coimbra

Praceta Mota Pinto

3000-075 Coimbra

Telefone: 239701517; Fax: 239701517

E-mail: sandraflopes@sapo.pt

 

Recebido para publicação: 23/04/2008

Aceite para publicação: 16/04/2009