[Fatal rickets in the fetus and undiagnosed maternal celiac disease]. 2011

Josep Soler-Bel, and Irene Veganzones, and Alexandra Navarro, and Fernando Ramos, and Elena Serra-Buxeda, and Joan Carles Ferreres
Servicio de Medicina Interna, Hospital Sant Joan de Déu de Manresa, Althaia, Xarxa Assistencial de Manresa, Barcelona, España.

Celiac disease is a relatively frequent enteropathy associated with a wide range of clinical manifestations, due in part to malabsorption. In women, it has been associated with obstetric and gynecological alterations such as repeated miscarriages, intrauterine growth delay, premature delivery, and low birth weight. We present the case of a woman with undiagnosed celiac disease who gave birth to a stillborn foetus via normal delivery after 34 weeks of gestation. The foetus presented severe morphological alterations due to hypomineralization which were compatible with rickets. In the medical literature congenital rickets secondary to maternal celiac disease due to malabsorption is rare. We discuss the current knowledge on maternofoetal phospho-calcium metabolism and relate active celiac disease with severe hypocalcaemia during pregnancy and fatal rickets in the foetus. We recommend screening for celiac disease in pregnant women with signs of malabsorption or impaired fetal development.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011248 Pregnancy Complications Conditions or pathological processes associated with pregnancy. They can occur during or after pregnancy, and range from minor discomforts to serious diseases that require medical interventions. They include diseases in pregnant females, and pregnancies in females with diseases. Adverse Birth Outcomes,Complications, Pregnancy,Adverse Birth Outcome,Birth Outcome, Adverse,Complication, Pregnancy,Outcome, Adverse Birth,Pregnancy Complication
D002446 Celiac Disease A malabsorption syndrome that is precipitated by the ingestion of foods containing GLUTEN, such as wheat, rye, and barley. It is characterized by INFLAMMATION of the SMALL INTESTINE, loss of MICROVILLI structure, failed INTESTINAL ABSORPTION, and MALNUTRITION. Gluten Enteropathy,Sprue, Celiac,Sprue, Nontropical,Celiac Sprue,Gluten-Sensitive Enteropathy,Sprue,Disease, Celiac,Enteropathies, Gluten,Enteropathies, Gluten-Sensitive,Enteropathy, Gluten,Enteropathy, Gluten-Sensitive,Gluten Enteropathies,Gluten Sensitive Enteropathy,Gluten-Sensitive Enteropathies,Nontropical Sprue
D005260 Female Females
D005313 Fetal Death Death of the developing young in utero. BIRTH of a dead FETUS is STILLBIRTH. Fetal Mummification,Fetal Demise,Death, Fetal,Deaths, Fetal,Demise, Fetal,Fetal Deaths,Mummification, Fetal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012279 Rickets Disorders caused by interruption of BONE MINERALIZATION manifesting as OSTEOMALACIA in adults and characteristic deformities in infancy and childhood due to disturbances in normal BONE FORMATION. The mineralization process may be interrupted by disruption of VITAMIN D; PHOSPHORUS; or CALCIUM homeostasis, resulting from dietary deficiencies, or acquired, or inherited metabolic, or hormonal disturbances. Rachitis,Rachitides
D017809 Fatal Outcome Death resulting from the presence of a disease in an individual, as shown by a single case report or a limited number of patients. This should be differentiated from DEATH, the physiological cessation of life and from MORTALITY, an epidemiological or statistical concept. Fatal Outcomes,Outcome, Fatal,Outcomes, Fatal

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