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Published on: October 7, 2021
Celiac disease manifested by polyneuropathy and swollen ankles
Zlatko Djuric1, Borislav Kamenov, Vuka Katic
1Children's Hospital, Department of Gastroenterology, University of Nis School of Medicine, Dr Zoran Djindjic Blv 48, Nis, Serbia. zldjuric@yahoo.com
World Journal of Gastroenterology
|June 7, 2007
Summary
Celiac disease (CD) can manifest with varied neurological and physical symptoms, including polyneuropathy and edema. Early diagnosis through serology and biopsy, followed by a gluten-free diet, can significantly improve these extraintestinal manifestations.
Area of Science:
- Gastroenterology
- Neurology
- Immunology
Background:
- Celiac disease (CD) is an immune-mediated enteropathy triggered by gluten ingestion.
- Extraintestinal manifestations of CD can be diverse and may precede gastrointestinal symptoms.
- Neuropathy and edema are uncommon but recognized extraintestinal signs of celiac disease.
Observation:
- A 27-year-old male presented with bilateral ankle edema, distal sensory-motor polyneuropathy, and hypertransaminasemia.
- Initial investigations revealed myopathic changes and low bone mineral density.
- Despite extensive medical evaluations, the underlying cause remained undiagnosed.
Findings:
- Serological testing for celiac disease was positive, with elevated antitissue transglutaminase and antiendomysial antibodies.
- Small bowel biopsy confirmed total villous atrophy, diagnostic of celiac disease.
- Electromyoneurography showed improvement in polyneuropathy after initiating a gluten-free diet.
Implications:
- This case highlights the importance of considering celiac disease in patients with unexplained neurological and systemic symptoms.
- Early recognition of celiac disease through serologic screening and appropriate diagnostic workup is crucial.
- A gluten-free diet can effectively reverse neurological and other extraintestinal manifestations of celiac disease.
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