Tetany with hypomagnesemia, hypokalemia, and hypocalcemia as initial presentation of celiac disease

Celiac disease is a systemic immune-mediated disorder that occurs after the ingestion of gluten in genetically susceptible individuals. It is caused by a combination of genetic and environmental factors. The illness is often accompanied by extraintestinal complications including osteopenia to osteoporosis. Tetany, a very rare existing feature of celiac disease, is caused by severe hypocalcemia as a result of intestinal calcium malabsorption. Hypomagnesemia may be seen in the setting of diarrhea, malabsorption, and steatorrhea. Clinical features include neuromuscular hyperexcitability (tremor, tetany, seizures) and arrhythmias that are often due to accompanying hypokalemia, hypomagnesemia, and hypocalcemia. We aimed to represent a case of celiac disease with tetany as initial presentation.