Severe osteomalacia due to gluten-sensitive enteropathy.
This report discusses a severe case of osteomalacia due to gluten-sensitive enteropathy: it stresses the clinical features and describes an atypical form of gluten-sensitive enteropathy, in which gastroenterological symptoms were absent. Wasting and osteomalacia causing skeletal deformation with spontaneous fractures were observed in a 31-year-old woman who had marked hypophosphoremia, a tendency to low serum calcium levels and slight multi-deficiency anaemia. The patient was in a state of depression. The causes of osteomalacia and then a general malabsorption syndrome were investigated. Anti-gliadin antibodies were positive. Histological tests on duodenal mucous revealed a pattern indicative of gluten-sensitive enteropathy. A gluten-free diet was prescribed and at a check-up one month later the patient had improved markedly. Skeletal symptoms are predominant in 30% of atypical forms of gluten-sensitive enteropathy. The severity of this case was due to a late diagnosis.
Lupattelli
G
G
Clinica Medica I, Università degli Studi di Perugia.
Fuscaldo
G
G
Castellucci
G
G
Ciuffetti
G
G
Pelli
M A
MA
Mannarino
E
E
D000208:Acute Disease; D000328:Adult; D001842:Bone and Bones / Q000000981:diagnostic imaging; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005598:Fractures, Spontaneous / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D010018:Osteomalacia / Q000175:diagnosis / Q000209:etiology*; D011859:Radiography