Histologically Confirmed Celiac Disease in a Multifactorial Primary-Care Presentation with Psychiatric, Musculoskeletal, and Hepatic Findings: A Case Report.
Markedly elevated tissue transglutaminase IgA antibody confirmed celiac disease diagnosis
Histologically Confirmed Celiac Disease in a Multifactorial Primary-Care Presentation with Psychiatric, Musculoskeletal, and Hepatic Findings: A Case Report.
Celiac disease (celiac disease) is an immune-mediated enteropathy with gastrointestinal and extraintestinal manifestations.
This case report describes a confounder-aware diagnostic approach to histologically confirmed celiac disease in a patient with a multifactorial primary-care presentation.
We report a single-patient, de-identified reflective case from routine family medicine practice, organized according to CARE case-report principles.
Radiographs showed mild osteoarthritis and osteopenia without erosive arthropathy.
Computed tomography excluded malignancy but showed severe diffuse hepatic steatosis and mild pancreatic atrophy.
During the diagnostic episode, small-bowel biopsy demonstrated moderate-to-severe crypt hyperplastic villous atrophy with increased intraepithelial lymphocytes, and gastric biopsies showed no significant pathology; the histology was consistent with celiac disease.
This case supports targeted celiac disease testing when anxiety or depressive symptoms occur alongside gastrointestinal symptoms, weight loss, arthralgia, hypothyroidism or documented thyroid autoimmunity, anemia, osteopenia, or liver-test abnormalities.
Histology and repeat serology confirmed the diagnosis, but the psychiatric and hepatic manifestations still require cautious interpretation because hypothyroidism, alcohol exposure, steatotic liver disease, and simultaneous treatments also shaped the clinical course.