Association of Celiac Disease with Inflammatory Bowel Disease and Colonic Cancer and liver Involvement in a Case of β-Thalassemia Minor.

A review of the literature suggests a potential association between celiac disease and inflammatory bowel disease (IBD), which may explain why both disorders are often present concurrently in one patient or in her/his first-degree relatives. In addition, a wide spectrum of liver injuries in patients may be related to celiac disease, including: Reactive hepatitis, autoimmune liver diseases, acute liver failure, cryptogenic cirrhosis and hepatocellular carcinoma. Mangiagli et al (2) reported a case of celiac disease in an adolescent with thalassemia major characterised by anorexia, arrest of weight gain and short stature. Another case of celiac disease and thalassemia major was reported in a study performed by Acquaviva (1) in Italy. Revealing the association between celiac disease and β-thalassemia highlights why a low threshold for the diagnosis of celiac disease should be considered in β-thalassemia patients with a history and/or clinical indications that are suggestive of celiac disease. Likewise, it is also recommended that diagnosis thresholds are lowered for thalassemic patients who present with short stature. Patients with celiac disease have a greater predisposition to IBD and liver involvement. Therefore, we also recommend colonoscopy and screening for asymptomatic and symptomatic liver diseases in celiac patients, as well as screening for celiac disease in all patients with IBD and autoimmune or cryptogenic liver disorders.