Coeliac crisis with severe hypokalaemia in an adult

Abstract

Coeliac crisis is a rare life-threatening presentation of coeliac disease, in which acute dramatic metabolic derangements are present. It is observed mainly in children less than two years of age. In adults, coeliac disease usually has an indolent course and presents with mild gastrointestinal symptoms or may even be asymptomatic and present with long term complications including anaemia, osteoporosis and infertility. This case describes a 38 year old gentleman who presented with acute diarrhoea that led rapidly to severe metabolic disturbances including life threatening hypokalaemia. This case illustrates the heterogeneous clinical course of coeliac disease and the importance of considering it in the differential diagnosis of adult patients presenting with acute diarrhoea and metabolic disturbances.