title: Celiac disease as a rare cause of primary amenorrhea: a case report.
abstract: BACKGROUND
  Primary amenorrhea can be due to abnormal functioning of the hypothalamic-pituitary axis or malformation of müllerian structures. Malnutrition due to chronic malabsorption can alter the axis and can be a cause of primary amenorrhea.
  
  
  METHODS
  A 20-year-old woman presented to us with primary amenorrhea and failure of development of secondary sexual characteristics. She had significant weight loss in spite of normal intake of diet. On investigation, she had microcytic hypochromic anemia, and her follicle-stimulating hormone and luteinizing hormone levels were low, while the thyroid-stimulating hormone and prolactin levels were normal. Her duodenal biopsy showed villus atrophy, and IgA antiendomysial antibody was positive, suggestive of celiac disease. The patient's condition improved markedly and attained menarche after 6 months of a gluten-free diet.
  
  
  CONCLUSIONS
  Celiac disease should be considered in patients presenting with malnutrition and primary amenorrhea.
authors.affiliation: Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Rae Bareli Road, Lucknow, U.P., India. mandakini@sgpgi.ac.in
authors.forename: Mandakini
authors.initials: M
authors.lastname: Pradhan
authors.lastname: Manisha
authors.forename: Renu
authors.initials: R
authors.lastname: Singh
authors.forename: Sadhana
authors.initials: S
authors.lastname: Dhingra
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D002446:Celiac Disease / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000178:diet therapy / Q000473:pathology; D003937:Diagnosis, Differential; D018753:Diet, Protein-Restricted; D005260:Female; D005983:Glutens; D006801:Humans; D044342:Malnutrition / Q000150:complications / Q000175:diagnosis
chemical_list: D005983:Glutens