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Intractable seizures and metabolic bone disease secondary to celiac disease

Vashishth P Maniar1, Sameer S Yadav, Yojana A Gokhale

  • 1Department of Medicine, Lokmanya Tilak Muncipal Medical College and General Hospital, Sion, Mumbai.

The Journal of the Association of Physicians of India
|December 31, 2010
PubMed

Insights

Celiac disease can present with neurological symptoms like seizures due to malabsorption. A gluten-free diet effectively treats these seizures and related deficiencies, not just calcium and vitamin D supplements.

Area of Science:

  • Gastroenterology
  • Neurology
  • Pediatrics

Background:

  • Celiac disease (CD) is a gluten-sensitive enteropathy with diverse clinical presentations.
  • Atypical, non-diarrheal presentations of CD are often overlooked, delaying diagnosis.

Observation:

  • Three young female patients presented with intractable seizures, hypocalcemia, rickets/osteomalacia, and anemia.
  • These symptoms suggested malabsorption, prompting consideration of celiac disease.

Findings:

  • Celiac disease diagnosis was confirmed via serological tests (IgA transglutaminase, IgG antigliadin antibodies) and duodenal biopsy.
  • A gluten-free diet resolved seizures and corrected hypocalcemia and anemia in all patients.

Implications:

  • Hypocalcemia presenting as intractable seizures can be an atypical manifestation of celiac disease.
  • Treating the underlying celiac disease with a gluten-free diet is crucial for managing these neurological and nutritional complications.

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