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Volume 8
Journal of Gastrointestinal & Digestive System
ISSN: 2161-069X
Page 60
JOINT EVENT
Pediatric Gastro 2018
Digestive Diseases 2018
October 22-23, 2018
October 22-23, 2018 Berlin, Germany
3
rd
International Conference on
Digestive and Metabolic Diseases
Pediatric Gastroenterology Hepatology & Nutrition
13
th
International Conference on
&
Celiac sprue presenting as exfoliative cheilitis, an immune mediated process: ACase Report
Wudassie melak
Rangpur Medical College, Bangladesh
Background:
celiac sprue an immune-mediated inflammation of the small intestine caused by sensitivity to dietary gluten and
related proteins in genetically sensitive individuals. In adults the presentation can be challenging for the physician. A patient
presented with an erythematous tongue and lip which was painless and constantly exfoliating.
Case presentation:
A 30-years-old male from Bahirdar, Ethiopia presented with an erythematous tongue and upper lip which
was exfoliating for more than 16 years. It was extending later to the lower lip upto the extent of obscuring the vermilion border.
It started on the upper lip as a small reddish triangular and erythematous lesion which later started peeling. He had mild
lactose intolerance but was not having serious abdominal complaints. He had a BMI of 20.6. He is now a university graduate
and works in a government institution. He regularly complains severe fatigue and sleepiness for the past two years and a recent
onset of forgetfulness and gait instability. His blood studies were normal. Peripheral morphology showed hypersegmented
neutrophils and serum B12 levels were low. IgA tTG and IgA AGA levels were significantly elevated. He was then put on a strict
gluten free diet and a parenteral cyanocobalamin. Within the first week he had significant improvement of the fatigue and his
lips became less and less dry with complete healing after 3 months.
Conclusion:
atypical presentation of celiac sprue in adults warrants high degree of suscpicion and early diagnostic intervention
to help detect such cases.
wudmelak@yahoo.comJ Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C7-083