Wallenberg syndrome as a sole presentation of celiac disease

Celiac sprue is a gluten sensitive enteropathy in which there is a small bowel villous atrophy associated with gastrointestinal and extraintestinal symptoms. True prevalence is difficult to ascertain because many patients have atypical symptoms or none at all. Few children display CNS symptoms such as peripheral neuropathy and cerebellar ataxia. So far, stroke in posterior circulation territory as a presentation for celiac disease has not been reported. We report a 15-year-old male patient who presented as Wallenberg syndrome without any positive medical history. Brain MRI confirmed infarction, and magnetic resonance angiography showed vertebral artery stenosis. Laboratory findings revealed anemia and positive serologic tests for celiac disease, and duodenal biopsy confirmed the disease. In any children with symptoms of vertebrobasilar insufficiency, celiac disease as a treatable cause must be considered.