It looks like inflammatory bowel disease, but it’s actually a celiac crisis

Celiac crisis is a very rare and life-threatening complication of celiac disease. It usually occurs at the onset of celiac disease, but later occurrence is not uncommon. The age range for this condition is broad; most cases tend to occur in the first two years of life, although recent reviews place the median age at around 18 years, and cases have also been described in adults. While there are no well-defined diagnostic criteria for the pediatric population, it typically manifests as profuse diarrhea, frequently accompanied by significant dehydration, electrolyte imbalances, hypoalbuminemia, lethargy, malnutrition, and even coagulopathy. It is believed that there are triggering factors, such as intercurrent infections, vaccination, surgery, or dietary indiscretions. The management includes supportive care to correct dehydration, electrolyte imbalances and malnutrition, and may initially require corticosteroid therapy or total parenteral nutrition, with early and gradual reintroduction of enteral nutrition to avoid refeeding syndrome.