engleski

Neurologic manifestations in adult celiac disease: case report

Celiac disease is more common than previously thought and a high index of suspicion is important in its diagnosis. Typically, cases of celiac disease present at the age of5-24 months with the symptoms of intestinal malabsorption, growth retardation, abnormal stools, abdominal distension, muscle wasting, hypotonia, poor appetite and low spirit. In adults, the symptoms of celiac disease may be highly variabile. The incidence of malignancies is also increased. Most of these are small bowel lymphomas and carcinomas of the esophagus and colon. ln some patients, the disease is associated with clinical dysfunction of the nervous system, manifesting variably as encephalopathy, cerebellar abnormalities, seizures, cerebral atrophy and dementia, brain stem encephalitis, cerebral vasculitis, myopathy, quadriparesis (metabolic), myelopathy, peripheral neuropathy, multifocal leukoencephalopathy, and psychiatric disorders. Presentation is made of a 47-year-old woman with misdiagnosed celiac disease, who first developed pain in the back which was treated with spinal support. She also complained of very severe bone pains. Finally, she was admitted to the hospital with a history of increasing difficulty on walking, weakness in her legs, urine incontinence, and 5-kg weight loss in four months. Celiac disease should therefore be considered in differential diagnosis in patients presenting with unexplained neurologic symptoms.

Celijakija; komplikacije; dijagnostika; centralni živčani sustav; prikaz slučaja

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