Case of the Quarter: Coeliac disease and granulomatous ileocolitis: an association or chance occurrence?

Enteric granulomatous inflammation can be caused by a number of conditions including Crohn’s disease, sarcoidosis, enteric infections, chronic granulomatous disease and also by drug reactions. Granulomas have also been described in microscopic colitis associated with certain medications and autoimmune diseases. The association of granulomatous ileocolitis with coeliac disease is not common. We present a case of coeliac disease with granulomatous ileocolitis with follow-up and repeat histology on a gluten-free diet.

Is routine screening for coeliac disease of value in people with type 1 diabetes?

This study aimed to assess the impact of screening positive for coeliac disease on a population of adults with type 1 diabetes. Fifty-three patients were identified with a positive screen for coeliac disease, out of a population of 2,752 individuals with type 1 diabetes (minimum prevalence 1.9%). Prior to screening, 32% of patients were asymptomatic. Only a fifth of patients found no improvement in well-being with a gluten-free diet and in those who followed a strict gluten-free diet the improvement in well-being was greater (p=0.034). Screening was felt to be beneficial by 73%.

Coeliac disease and granulomatous ileocolitis: an association or chance occurrence?

Enteric granulomatous inflammation can be caused by a number of conditions including Crohn’s disease, sarcoidosis, enteric infections, chronic granulomatous disease and also by drug reactions. Granulomas have also been described in microscopic colitis associated with certain medications and autoimmune diseases. The association of granulomatous ileocolitis with coeliac disease is not common. We present a case of coeliac disease with granulomatous ileocolitis with follow-up and repeat histology on a gluten-free diet.