title: Multiphasic disseminated encephalomyelitis followed by optic neuritis in a child with gluten sensitivity.
abstract: Multiphasic disseminated encephalomyelitis (MDEM) followed by optic neuritis (ON) has been described as a new entity in recent years. Gluten encephalopathy has also been recognized as a neurological manifestation of celiac disease. Accurate diagnosis of both is important due to the therapeutic implications. We report a girl presenting with recurrent encephalopathic polyfocal demyelinating episodes followed by optic neuritis, and a clinical history suggestive of gluten sensitivity. She had persistently high ESR, neutrophilia, and tested positive for anti-MOG (myelin oligodendrocyte glycoprotein) antibody. She responded well to methylprednisolone in each relapse, and achieved remission for a year after azathioprine was added.
authors.affiliation: Paediatric Neurology Unit, Department of Paediatrics, Hospital Kuala Lumpur, Malaysia chingbihhwa@yahoo.com.
authors.forename: B H
authors.initials: BH
authors.lastname: Ching
authors.affiliation: Paediatric Neurology Unit, Department of Paediatrics, Hospital Kuala Lumpur, Malaysia.
authors.forename: A R
authors.initials: AR
authors.lastname: Mohamed
authors.affiliation: Paediatric Neurology Unit, Department of Paediatrics, Hospital Kuala Lumpur, Malaysia.
authors.forename: T B
authors.initials: TB
authors.lastname: Khoo
authors.affiliation: Paediatric Neurology Unit, Department of Paediatrics, Hospital Kuala Lumpur, Malaysia.
authors.forename: H I H M
authors.initials: HI
authors.lastname: Ismail
mesh_terms: D001921:Brain / Q000473:pathology; D002446:Celiac Disease / Q000150:complications*; D002675:Child, Preschool; D004673:Encephalomyelitis, Acute Disseminated / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009902:Optic Neuritis / Q000150:complications*
keywords: Multiphasic disseminated encephalomyelitis; gluten sensitivity; optic neuritis