ACUTE CELIAC CRISIS PRESENTING AS SEVERE MALABSORPTIVE DIARRHEA AND HEMODYNAMIC INSTABILITY IN AN ADULT MALE: A CASE REPORT.

Celiac crisis is a rare and life-threatening manifestation of celiac disease characterized by acute severe diarrhea, dehydration, and metabolic disturbances requiring hospitalization. Although commonly described in children, it is infrequently reported in adults and may pose a diagnostic challenge. We report the case of a 31-year-old previously healthy male who presented with profuse watery diarrhea, profound weight loss, hypotension, electrolyte imbalance, hypoalbuminemia, and metabolic acidosis. Extensive infectious and inflammatory evaluations were negative. Serologic testing revealed markedly elevated anti-tissue transglutaminase and anti-endomysial antibodies. Upper endoscopy demonstrated scalloping and atrophic duodenal mucosa, while histopathology confirmed villous atrophy with crypt hyperplasia and increased intraepithelial lymphocytes. A diagnosis of celiac crisis was established. The patient was successfully managed with aggressive fluid resuscitation, electrolyte correction, nutritional support, and strict gluten-free diet, resulting in rapid clinical recovery. This case highlights the importance of considering celiac crisis in adults presenting with severe unexplained diarrhea and metabolic derangements to enable early diagnosis and timely management.