Stroke and dilated cardiomyopathy associated with celiac disease.
Celiac disease (CD) is manifested by a variety of clinical signs and symptoms that may begin either in childhood or adult life. Neurological symptoms without signs of malabsorption have been observed for a long time in CD. In this report, an 8-year-old girl with CD presented with rarely seen dilated cardiomyopathy and stroke. The girl was admitted with left side weakness. Her medical history indicated abdominal distention, chronic diarrhea, failure to thrive, and geophagia. On physical examination, short stature, pale skin and a grade 2 of 6 systolic murmur were detected. Muscle strength was 0/5 on the left side, and 5/5 on the right side. Coagulation examinations were normal. Tests for collagen tissue diseases were negative. Factor V Leiden and prothrombin GA20210 mutations were negative. Tandem mass spectrophotometry and blood carnitine profiles were normal. Brain magnetic resonance imaging and cerebral angiography showed an infarction area at the basal ganglia level. Examinations of serologic markers and intestinal biopsy revealed CD. We emphasize that in differential diagnosis of ischemic stroke, CD should be kept in mind.
Doğan
Murat
M
Department of Pediatric Endocrinology, Yuzuncu Yil University, Medical School, 65100 Van, Turkey. doganmurat.md@gmail.com
Peker
Erdal
E
Cagan
Eren
E
Akbayram
Sinan
S
Acikgoz
Mehmet
M
Caksen
Huseyin
H
Uner
Abdurrahman
A
Cesur
Yasar
Y
D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000209:etiology*; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis; D002533:Cerebral Angiography; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D020521:Stroke / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*
N Engl J Med. 2002 Jan 17;346(3):180-8
11796853
Scand J Gastroenterol. 1998 Aug;33(8):817-21
9754728
J Neurol. 2004 Nov;251(11):1393-7
15592736
Gastroenterology. 1992 Jan;102(1):330-54
1727768
Gastroenterology. 2001 Feb;120(3):636-51
11179241
N Engl J Med. 2001 Dec 13;345(24):1740-6
11742048
Circulation. 2002 Jun 4;105(22):2611-8
12045166
Eur J Neurol. 2008 Sep;15(9):969-72
18637824
J Pediatr Gastroenterol Nutr. 2005 Jan;40(1):1-19
15625418
Eur J Neurol. 2001 Jul;8(4):373-4
11422441