Reversible inflammatory and vacuolar myopathy with vitamin E deficiency in celiac disease.
We report a patient with late-onset celiac disease and neurological manifestations including myopathy, polyneuropathy, and ataxia. Laboratory investigations showed anti-gliadin antibodies and severe vitamin E deficiency. Muscle biopsy revealed inflammatory infiltrates and rimmed vacuoles, similar to those found in inclusion-body myositis. A gluten-free diet and vitamin E supplementation reversed both the clinical neurological manifestations and the abnormalities in the muscle biopsy. Anti-gliadin antibodies were no longer present. This case illustrates the spectrum of neurological complications of celiac disease and documents the occurrence of reversible pathology resembling inclusion-body myopathy in the muscle.
Kleopa
Kleopas A
KA
Department of Clinical Neurosciences, Cyprus Institute of Neurology and Genetics, P.O. Box 23462, Nicosia, Cyprus.
Kyriacou
Kyriacos
K
Zamba-Papanicolaou
Eleni
E
Kyriakides
Theodoros
T
D000368:Aged; D002446:Celiac Disease / Q000150:complications / Q000178:diet therapy* / Q000473:pathology; D005983:Glutens / Q000009:adverse effects; D006801:Humans; D008297:Male; D009220:Myositis / Q000150:complications / Q000178:diet therapy* / Q000473:pathology; D018979:Myositis, Inclusion Body / Q000150:complications / Q000178:diet therapy* / Q000473:pathology; D014810:Vitamin E / Q000008:administration & dosage; D014811:Vitamin E Deficiency / Q000150:complications / Q000178:diet therapy* / Q000473:pathology
D014810:Vitamin E; D005983:Glutens