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Celiac disease manifested by polyneuropathy and swollen ankles

World Journal of Gastroenterology 2007年第18期13卷 2636-2638页

作者： Zlatko Djuric Borislav Kamenov Vuka Katic Children's Hospital Department of Gastroenterology University of Nis School of Medicine Nis Serbia Children's Hospital Department of Immunology University of Nis School of Medicine Nis Serbia Institute of Pathology University of Nis School of Medicine Nis Serbia

A 27-year-old male started to have his ankles swollen during his military service. He was examined at a military hospital where electromyoneurography showed the signs of distal sensory-motor polyneuropathy with axon demyelinization and weak myopathic changes, whereas histopathological examination of gastrocnemius muscle biopsy revealed some mild and nonspecific myopathy. Besides, he was found to have subcutaneous ankle tissue edemas and hypertransaminasemia. Due to these reasons, he was dismissed from the military service and examined at another hospital where bone osteodensitometry revealed low bone mineral density of the spine. However, his medical problems were not resolved and after the second discharge from hospital he was desperately seeing doctors from time to time. Finally, at our institution he was shown to have celiac disease (CD) by positive serology (antitissue transglutaminase and antiendomysial antibodies) and small bowel mucosal histopathological examination, which showed total small bowel villous atrophy. Three months after the initiation of gluten-free diet, his ankle edema disappeared, electromyoneurographic signs of polyneuropathy improved and liver aminotransferases normalized. Good knowledge of CD extraintestinal signs and serologic screening are essential for early CD recognition and therapy.

关键词： Celiac Polyneuropathy swollen ankles

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