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[Bilateral occipital calcification, epilepsy and coeliac disease: case report]
Carlos Henrique Souza Santos1, Iara Leda Brandão Almeida, Maria Durce Costa Gomes
1Setor de Neurologia Infantil, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
Insights
This case study highlights a pediatric patient with iron deficiency anemia, seizures, and brain calcifications, ultimately diagnosed with celiac disease. Early diagnosis and management of celiac disease are crucial for neurological and gastrointestinal symptoms.
Area of Science:
- Pediatric Neurology
- Gastroenterology
- Medical Imaging
Background:
- Presents a rare case of a six-year-old girl with a history of iron deficiency anemia and partial seizures.
- Neurological symptoms included bilateral occipital and posterior parietal gyral calcifications detected via CT and MRI.
Observation:
- The patient experienced frequent diarrhea episodes from six months of age.
- Seizures began in her third year and were managed with carbamazepine.
Findings:
- Blood tests for celiac disease (antigliadin, endomysial, and transglutaminase antibodies) were positive.
- Intestinal biopsy revealed villous atrophy, increased intraepithelial lymphocytes, and hypertrophic cryptae, confirming celiac disease.
Implications:
- This case underscores the importance of considering celiac disease in pediatric patients presenting with unexplained anemia, neurological abnormalities, and gastrointestinal issues.
- Highlights the link between celiac disease and neurological manifestations like seizures and brain calcifications.
- Suggests the need for comprehensive diagnostic workups to identify celiac disease in children with complex, multi-systemic symptoms.
Abstract:
We report a case of a six-year-old girl with frequent diarrhea episodes associated with ferroprive anemia from 6 months of age, normal neuromotor development and partial seizures initiated in her 3rd year which was controlled with carbamazepine. CT scan in her 5th year of age demonstrated gyral calcifications in the occipital and posterior parietal regions bilaterally. MRI has shown low signal areas in the axial T2 sequences corresponding to the gyral calcifications evident on the CT. Blood investigation for coeliac disease with antigliadin, endomysial and transglutaminase antibodies was positive and the intestinal biopsy has showed villous atrophy associated with an increased number of intraepithelial lymphocytes and hypertrophic criptae compatible with coeliac disease.
