Coexistence of celiac disease and systemic lupus erythematosus in a 6-year-old girl-case report.

Systemic lupus erythematosus (SLE) is a serious and potentially fatal syndrome characterized by an autoimmune assault on various organs and systems that may include the skin, joints, central nervous system, heart and kidneys. Recent research shows that gluten sensitivity causes more than just celiac disease and gluten has been linked to numerous autoimmune conditions. We report here a 6-year-old girl presenting with malaise, abdominal pain, loss of appetite, abdominal distension. After three weeks she developed other symptoms such as arthralgias, malar rash, being finally diagnosed with SLE and possible autoimmune hepatitis. The suspicion of celiac disease was based on a combination of symptoms (poor growth, iron deficiency anemia, chronic abdominal pain, abdominal distension, constipation, "sad child"), IgA deficiency, in the presence of SLE diagnosis. Positive diagnosis of celiac disease was confirmed by the presence of an anti IgG anti-transglutaminase antibodies titer of 120 EU/ml (normally less than 20 EU/ml). Small bowel biopsy showed a IIIB1 stage according to the Marsh classification. Three methylprednisolone pulses were promptly administered, followed by oral prednisone (2 mg/kg bw/day) with a good outcome.