Cobalamine deficiency associated with neuropathy and oral mucosal melanosis in untreated gluten-sensitive enteropathy.
A 32-year-old woman was admitted with complaints of difficulty in walking and hypoaesthesia and tingling in her legs. She had short stature and brown-black hyperpigmentation, cheliosis, dental irregularities and scars in the axillary regions. Neurological examination revealed mild, symmetric, predominantly distal weakness of the legs; deep tendon reflexes were depressed. There was glove-and-stocking decrease in pinprick and temperature perception but proprioception and light touch were normal. Investigations established a diagnosis of celiac disease; her neurological features improved on gluten-free diet, but oral pigmentation persisted.
Somay
Göksel
G
Department of Gastroenterology, Haydarpasa Numune Educational and Research Hospital, Istanbul, Turkey. gsomay@hotmail.com
Cevik
Deniz Mataraci
DM
Halaç
Gülistan Usak
GU
Abut
Evren
E
Erenoglu
Nuri Yasar
NY
D000328:Adult; D001706:Biopsy; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008548:Melanosis / Q000209:etiology*; D009061:Mouth Mucosa / Q000473:pathology; D020752:Neurocutaneous Syndromes / Q000209:etiology*; D010523:Peripheral Nervous System Diseases / Q000209:etiology*; D014806:Vitamin B 12 Deficiency / Q000209:etiology*