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Prolapso rectal como presentación inhabitual de enfermedad celiaca. A propósito de 2 casos clínicos / Rectal prolapse as an unusual presentation of celiac disease. Report of two cases
Errázuriz, Germán.
  • Errázuriz, Germán; Clínica las Condes. Santiago. CL
Rev. chil. pediatr ; 88(6): 798-802, dic. 2017. tab, graf
Article in Spanish | LILACS | ID: biblio-900055
RESUMEN
Resumen

Introducción:

El prolapso rectal (PR) está relacionado a un aumento de presión intrabdominal, patología del piso pélvico o esfínter anal, siendo las causas más frecuentes la constipación, fibrosis quística, tos convulsiva y diarrea disentérica. La enfermedad celiaca no está considerada entre las patologías relacionadas a PR.

Objetivo:

Dar a conocer una asociación escasamente descrita entre PR y enfermedad celiaca. Casos Clínicos Se presentan 2 preescolares en quienes el motivo de consulta fue el PR, cuyo estudio se enfocó como diarrea prolongada, debido al antecedente de deposiciones de consistencia pastosa. En los exámenes destacaron títulos de anticuerpos anti-transglutaminasa tisular (Ac anti-tTG) elevados, y biopsias duodenales con atrofia vellositaria y aumento de linfocitos in-traepiteliales, compatible con enfermedad celiaca. Ambos tuvieron una excelente respuesta a la dieta libre de gluten, con rápida normalización de las deposiciones, sin nuevos episodios de PR, desarrollo pondoestatural normal y Ac anti-tTG negativos en los controles anuales a 5 años de seguimiento.

Conclusiones:

Aunque la asociación entre PR y enfermedad celiaca prácticamente no ha sido descri ta, debe considerarse en pacientes que se presenten con PR.
ABSTRACT
Abstract

Introduction:

Rectal prolapse (RP) is related to an increase of intra-abdominal pressure, pelvic floor disease or anal sphincter. The most common causes of RP are constipation, cystic fibrosis, whooping cough and dysenteric diarrhea. However, celiac disease is not considered among the pathologies re lated to RP.

Objective:

To present a scarcely described association between RP and celiac disease. Clinical Cases We presented 2 preschoolers in whom the reason for consultation was RP, whose study was focused on as prolonged diarrhea, due to the antecedent of pasty consistency of stools. The tests showed elevated anti-tissue transglutaminase (anti-tTG) antibody titers, and duodenal biopsies with villous atrophy and increased intraepithelial lymphocytes, consistent with celiac disease. Both had an excellent response to the gluten-free diet, with rapid normalization of depositions, without presenting any episodes of RP after treatment. Both with normal staturo-ponderal development and anti-tTG-negative controls at the annual 5-year follow-up.

Conclusions:

Although the association between RP and celiac disease has not been described yet, it should be considered in diagnosis and treatment.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Celiac Disease / Rectal Prolapse Limits: Child, preschool / Female / Humans / Infant / Male Language: Spanish Journal: Rev. chil. pediatr Journal subject: Pediatrics Year: 2017 Type: Article Affiliation country: Chile Institution/Affiliation country: Clínica las Condes/CL

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Full text: Available Index: LILACS (Americas) Main subject: Celiac Disease / Rectal Prolapse Limits: Child, preschool / Female / Humans / Infant / Male Language: Spanish Journal: Rev. chil. pediatr Journal subject: Pediatrics Year: 2017 Type: Article Affiliation country: Chile Institution/Affiliation country: Clínica las Condes/CL