Coeliac disease associated with peripheral neuropathy in a child: a case report.
Clinical features and pathological findings of sural nerve biopsy are reported of a 3-year-old child affected with coeliac disease who developed a progressive polyneuropathy, unresponsive to a gluten-free diet, nor to vitamin E and folic acid supply. There was no evidence of malabsorption, nor of blood factor deficiency, nor of metabolic abnormalities which might account for the neuropathy. A sural nerve biopsy showed marked loss of myelinated fibres without evidence of regenerative phenomena. Distal involvement and features of nerve pathology are consistent with a "dying-back" mechanism to underlie the nerve damage. The lack of response to a gluten-free diet suggests that direct toxicity of gliadin is not implicated.
Simonati
A
A
Department of Neurological and Visual Sciences, University of Verona, Italy.
Battistella
P A
PA
Guariso
G
G
Clementi
M
M
Rizzuto
N
N
D001706:Biopsy; D002446:Celiac Disease / Q000150:complications*; D002675:Child, Preschool; D018450:Disease Progression; D006801:Humans; D008297:Male; D010523:Peripheral Nervous System Diseases / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D013497:Sural Nerve / Q000473:pathology