{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:18:36Z","timestamp":1777936716237,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Pediatr"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>Celiac disease (CD) is a chronic autoimmune condition with intestinal and extra-intestinal features. Extra intestinal features including hematological, neurological, and endocrine symptoms are seen more frequently in elder children. A 4\u2009years 7\u2009months old male child presented in clinic with history of abdominal pain and diarrhea on and off for 1\u2009year. On examination, he was hemodynamically stable, pale, and malnourished with distended abdomen. He was investigated for CD, Anti TTG IgA &lt;0.1 (positive &gt;10), Anti TTG IgG 13 (positive &gt;10). To confirm celiac disease, Esophagogastroduodenoscopy (EGD) was done which was consistent with diagnosis of Celiac disease (MARSH Type 3a). Gluten free diet was advised. Later, after 12\u2009days he again presented with jaundice, fever, anorexia, and dark colored urine and irritability. He was admitted for fulminant hepatic failure, his workup revealed direct hyperbilirubenemia, ANA +ve, and hyper IgG. Liver biopsy confirmed autoimmune hepatitis. Further workup for anemia showed reticulocyte count 7.1, LDH 423, direct and indirect coombs test was positive confirming autoimmune hemolytic anemia. Child responded well to Azathioprine and prednisolone with clinical improvement. We report a rare presentation of celiac disease with polyautoimmunity in a young child. Case reports of autoimmune hepatitis with CD patients have been reported in adult patients. Association of celiac disease with autoimmune hemolytic anemia and autoimmune hepatitis is a distinct and rare condition.<\/jats:p>","DOI":"10.1177\/11795565221120565","type":"journal-article","created":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T08:20:24Z","timestamp":1661415624000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Celiac Disease With Autoimmune Hemolytic Anemia and Autoimmune Hepatitis in a Young Child: Case Report and Literature Review"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7950-4863","authenticated-orcid":false,"given":"Sabeen Abid","family":"Khan","sequence":"first","affiliation":[{"name":"Paediatric, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Imran","sequence":"additional","affiliation":[{"name":"Paediatric, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qamar","family":"Ali","sequence":"additional","affiliation":[{"name":"Consultant Paediatric Gastroenterologist, Shifa International Hospital, Islamabad, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Munir Iqbal","family":"Malik","sequence":"additional","affiliation":[{"name":"Consultant Paediatric Gastroenterologist, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,8,25]]},"reference":[{"key":"bibr1-11795565221120565","doi-asserted-by":"publisher","DOI":"10.5694\/mja16.00788"},{"key":"bibr2-11795565221120565","doi-asserted-by":"publisher","DOI":"10.5409\/wjcp.v10.i4.53"},{"key":"bibr3-11795565221120565","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2018.09.001"},{"key":"bibr4-11795565221120565","first-page":"366","volume-title":"Hyams, Pediatric Gastrointestinal and Liver Disease","volume":"2011","author":"Riccardo T","edition":"4"},{"key":"bibr5-11795565221120565","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-017-0577-x"},{"key":"bibr6-11795565221120565","doi-asserted-by":"publisher","DOI":"10.1016\/j.gastrohep.2018.05.024"},{"key":"bibr7-11795565221120565","doi-asserted-by":"publisher","DOI":"10.1177\/0961203320961469"},{"key":"bibr8-11795565221120565","doi-asserted-by":"publisher","DOI":"10.1097\/01.mpg.0000450394.30780.ea"},{"key":"bibr9-11795565221120565","first-page":"5","volume":"81","author":"Sahin Y","year":"2018","journal-title":"Acta Gastroenterol Belg"},{"key":"bibr10-11795565221120565","first-page":"712","volume":"72","author":"Trovato CM","year":"2021","journal-title":"JPGN"},{"key":"bibr11-11795565221120565","first-page":"116","volume":"9","author":"Villavicencio Kim J","year":"2021","journal-title":"J Clin Transl Hepatol"},{"key":"bibr12-11795565221120565","first-page":"167","volume":"3","author":"Emami MH","year":"2012","journal-title":"Int J Prev Med"},{"key":"bibr13-11795565221120565","volume":"5","author":"Iqbal U","year":"2017","journal-title":"J Investig Med High Impact Case Rep"},{"key":"bibr14-11795565221120565","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.20047"},{"key":"bibr15-11795565221120565","doi-asserted-by":"publisher","DOI":"10.2165\/11593150-000000000-00000"},{"key":"bibr16-11795565221120565","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15000"},{"key":"bibr17-11795565221120565","first-page":"162","volume":"20","author":"Eliseu L","year":"2013","journal-title":"GE J Port Gastrenterol"},{"key":"bibr18-11795565221120565","unstructured":"Diagnosis and management of paediatric autoimmune hepatitis AIH. 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