A Celiac Crisis in an Adult: Raising Awareness of a Life-threatening Condition

OBJECTIVES: The Authors report the case of a 56-year-old man with celiac disease, who after ingesting a food containing gluten and experiencing a flu-like syndrome, developed severe diarrhea, vomiting, weight loss (15 kg), hypotension, renal dysfunction, hypokalemia and metabolic acidosis. MATERIALS AND METHODS: Admission to the Intensive Care Unit and exclusion of an infectious cause was determined. RESULTS: After receiving noradrenaline, methylprednisolone and correction of ionic disturbances, the patient recovered rapidly and had no further complication. CONCLUSION: The authors intend to increase awareness of celiac crisis, because despite being extremely rare in adults, it is potentially fatal and an quick diagnosis and treatment are crucial. LEARNING POINTS: Celiac crisis is an acute, life-threatening presentation of celiac disease. Its clinical presentation consists of severe diarrhea, metabolic disturbances (namely hypokalemia, hyponatremia, hypomagnesemia, hypocalcemia and metabolic acidosis), hypoproteinemia and dehydration. Hospitalization and correction of metabolic imbalance with intravenous fluids are required, with corticotherapy being necessary in some cases.