Clinical case of delayed diagnosis of celiac enteropathy

The article presents a clinical case of late diagnosis of celiac enteropathy. Celiac disease is an immune‑mediated enteropathy that results in intolerance to dietary gluten. This disease affects the small intestine, and course variability is typical for it. Some patients have no symptoms or only signs of nutritional deficiencies. In other cases, severe manifestations associated with gastrointestinal, extraintestinal symptoms and malabsorption syndrome are observed. Female patient A., 33 years old, came to the clinic with complaints of bloating, loose stools, weight loss, swelling of the lower extremities, fatigue, weakness and hair loss. The disease began to manifest itself in August 2020, when the patient began to lose weight and suffer from bloating, but did not seek medical help. In 2021, as a result of research, the local therapist diagnosed iron deficiency anemia and prescribed appropriate medications. In subsequent years, the patient continued to see doctors, including a gastroenterologist, who made diagnosis of chronic pancreatitis and intestinal dysbiosis. However, in March 2023, new symptoms appeared, such as swelling of the lower extremities and cramps, which prompted the patient to continue examinations. Additional studies showed the presence of cytolytic syndrome, coagulopathy, decreased folic acid and hypoproteinemia, electrolyte disturbances, high titers of anti‑tissue transglutaminase antibodies and endoscopy signs of celiac disease. As a result of further examination, a diagnosis was made of celiac disease with a clinical variant of the classical type. The authors conclude that this clinical case is an example of late diagnosis of celiac disease and highlight the importance of promptly seeking medical attention for symptoms and risk factors. Diagnosis of celiac disease is based on clinical manifestations, the results of serological studies and morphological examination of the small intestine. Overall, this article highlights the importance of early diagnosis and treatment of celiac disease, and the need for additional research to confirm the diagnosis. This clinical case confirms the importance of timely diagnosis of celiac disease and awareness of its various clinical manifestations. The importance of increasing awareness of celiac disease among health care workers and the public is emphasized for timely diagnosis and proper management of this disease.