title: Rare association of celiac disease with myasthenia gravis in a patient with other immune disorders: a case report.
abstract: BACKGROUND
  Celiac disease is described in association with several autoimmune diseases, but rarely with myasthenia gravis.
  
  
  METHODS
  We describe the case of a 31-year-old white woman with celiac disease who presented manifestations related to a hyperactive immune system, including macroamylasemia, false-positive anti-HCV, positive antinuclear antibody, and Raynaud's phenomenon. The introduction of a gluten-free diet (GFD) resolved these features, but myasthenia gravis (MG) symptoms unexpectedly occurred on that occasion.
  
  
  CONCLUSIONS
  The role of a GFD in the course of autoimmune diseases has been studied and improvement has been reported in many diseases. However, there is no consensus in the literature regarding the course of neurological disorders associated with celiac disease. In the present case, a GFD did not prevent the appearance of symptoms related to myasthenia gravis. There are few reports on the association of celiac disease with myasthenia gravis and therefore little is known about the course and time of onset of myasthenia in celiac patients. The present case increases the knowledge about this unusual autoimmune neurological disease associated with celiac disease.
authors.affiliation: Internal Medicine Department, State University of Campinas (UNICAMP), Brazil.
authors.forename: Marcela
authors.initials: M
authors.lastname: de Almeida Menezes
authors.affiliation: Department of Internal Medicine, State University of Campinas, Brazil.
authors.forename: Vírginia Lúcia
authors.initials: VL
authors.lastname: Ribeiro Cabral
authors.affiliation: Department of Internal Medicine, State University of Campinas, Brazil.
authors.forename: Sônia S
authors.initials: SS
authors.lastname: Lorena
authors.affiliation: Department of Neurology, State University of Campinas, Brazil.
authors.forename: Anamarli
authors.initials: A
authors.lastname: Nucci
authors.affiliation: Department of Internal Medicine, State University of Campinas, Brazil.
authors.forename: Priscila
authors.initials: P
authors.lastname: Andrade Santana
authors.affiliation: Department of Internal Medicine, State University of Campinas, Brazil.
authors.forename: Cecília
authors.initials: C
authors.lastname: Queiroz Silva
mesh_terms: D000328:Adult; D002446:Celiac Disease / Q000097:blood / Q000150:complications* / Q000178:diet therapy; D055050:Diet, Gluten-Free; D005260:Female; D006801:Humans; D007154:Immune System Diseases / Q000150:complications*; D009157:Myasthenia Gravis / Q000150:complications* / Q000178:diet therapy / Q000188:drug therapy