Occult celiac disease presenting as non-alcoholic chronic calcific pancreatitis

الملخص EN

-This report describes a diabetic Yemeni male with pan-creatic exocrine insufficiency and calcification.

Persistent diarrhea and weight loss led tofurther investigation and a diagnosis of celiac disease with an excellent response to a gluten free diet.

Celiac disease and chronic calcifying pancreatitis with exo-crine insufficiency are both relatively frequent causes of the malabsorption syndrome؛■‘؛*.

Exocrine pancreatic insufficiency has been observed in patients with celiac disease.

Usually this impairment is mild in nature, detectable only on pancreatic func-tional studies؛^.

The co-existence of celiac disease and advanced exocrine pancreatic insufficiency in an individual is rare and there are only seven such cases reported in the literature'^'.

Case Report: In 1995 a 45 year-ol،l Yemeni male was referred for évalua-tion of diarrhea, abdominal pain and weight loss.

He had 4 - 6 watery stools without mucus or blood.

Lower abdominal crampy pain preceded these episodes and was relieved by passage of' stool.

He also had nocturnal diarrhea.

There was no history of drug abuse or alcohol intake.

Past history included in^in-dependent diabetes treated for four years, benign prostatic hypertrophy and mild azotemia.

Physical examination was remarkable for emaciation with a weight of only 42 kg and bilateral pitting pedal edema.

Investi-gâtions revealed a normochromic normocytic anemia with a Hb of 10.3 gm/dl, Hct31,MC¥96, MCH31.4, MCHC 32.6,WBC 9800, platelet count of 322000 and sedimentation rate of 5mm fall up to the first hour, hypoalbuminemia with a serum albu-mill of 29 gm/l (nl 35 to 50 g/L) and steatorrhea with bulky