Navigating a Complex Clinical Conundrum: The Coexistence of Crohn’s Disease, Celiac Disease, and Ankylosing Spondylitis
Benayad Aourarh *
Department of Gastroenterology, Military Teaching Hospital Mohamed V Rabat, Morocco.
Aziz Aourarh
Department of Gastroenterology, Military Teaching Hospital Mohamed V Rabat, Morocco.
Lina Belkouchi
Department of Radiology, Military Teaching Hospital Mohamed V Rabat, Morocco.
Rachida Saouab
Department of Radiology, Military Teaching Hospital Mohamed V Rabat, Morocco.
Mohamed Amine Essaoudi
Department of Pathology, Military Teaching Hospital Mohamed V Rabat, Morocco.
*Author to whom correspondence should be addressed.
Abstract
The coexistence of Crohn’s disease (CrD), celiac disease (CD), and ankylosing spondylitis (AS) is exceptionally rare and poses significant diagnostic and therapeutic challenges. We report the case of a 27-year-old woman with alpha-thalassemia and a nonspecific genetic disorder, who presented with chronic diarrhea, severe weight loss, and Koenig syndrome. Laboratory results confirmed malabsorption syndrome, anemia, hypoalbuminemia, and elevated inflammatory markers, with colonoscopy and biopsies diagnosing CrD and CD. Six months later, she developed peripheral arthritis, leading to a diagnosis of AS. Treatment with corticosteroids, azathioprine, a gluten-free diet, and infliximab led to clinical remission. This case highlights the importance of a diagnostic approach in distinguishing overlapping autoimmune conditions and demonstrates the efficacy of infliximab in managing both gastrointestinal and rheumatologic manifestations.
Keywords: Crohn-celiac-ankylosing spondylitis, Koenig syndrome, gluten-free diet