Association of asymptomatic celiac disease and Crohn's disease

A 24-year-old woman had Crohn's colitis which had been diagnosed in 1997. The patient was given sulfazalazine and responded well. Antiendomysial and antigliadin antibodies were positive. Diagnosis of celiac disease was confirmed by duodenal biopsy showing villous atrophy and an increased number of lymphocytes infiltrating the epithelium. Few cases associating Crohn's disease and celiac disease have been reported. This case illustrates the complexity of the pathogenic mechanisms in these two disease. Our patient required a gluten-free diet although the celiac disease was asymptomatic, basically to avoid the risk of malignancy associated with celiac disease.