Letters to the Editor: Coeliac Disease Misdiagnosed as Trichotillomania in a 5-Year-Old Girl

    August 2008 in “ Journal of Paediatrics and Child Health ”
    Iain McCallum, Cathy Van zanten, Imran Inam, Wendy Craig, Gamal Mahdi, Richard J. Thompson
    TLDR A gluten-free diet resolved a girl's symptoms, revealing undiagnosed Coeliac disease as the cause.
    A 5-year-old girl presented with hair loss, iron deficiency anemia, and gastrointestinal symptoms, which were initially attributed to a trichobezoar caused by trichotillomania. However, further investigation revealed underlying Coeliac disease, which likely led to malabsorption, anemia, and pica, manifesting as hair ingestion. This case highlighted the importance of considering Coeliac disease in similar presentations, as the condition was confirmed through duodenal biopsies showing villous atrophy and positive IgA antibodies. Treatment with a gluten-free diet resolved the anemia and improved her overall health. This was the first reported case of Coeliac disease presenting in this manner.
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