ABSTRACT The coexistence of celiac disease and giardiasis is an uncommon and potentially dangerous clinical scenario that presents diagnostic and therapeutic challenges. We describe a 48-year-old man with persistent diarrhea for 3 weeks and new onset bilateral upper and lower extremity weakness. Laboratory results revealed severe hypokalemia and positive celiac serologies. In addition, stool testing was positive for Giardia lamblia , which likely contributed to the severity of his symptoms and resulting electrolyte abnormalities. This unique presentation reinforces the recommendation to combine serologic, histologic, and infectious workup when evaluating severe diarrhea, even in cases of suspected celiac disease.
Forest et al. (Sun,) studied this question.