Celiac disease association with other autoimmune disorders: Three case reports

Dorottya Kocsis, Melinda Csaplár, Eszter Jócsák, Péter Pák, Zsuzsanna Tóth, Pál Miheller, László Herszényi, Miklós Tóth, Zsolt Tulassay, Mark Juhasz

Abstract


Background: A 15 year period retrospective study at our celiac centre (Semmelweis University 2nd Department of Internal Medicine) has found, that 91 out of 248 coeliac patients (20 male, 71 female) also suffered from at least one autoimmune disease associated with celiac disease. The objective of the following case reports is to demonstrate the protean faces of celiac disease and the association tendency with other autoimmune disorders.
Case presentation: 34-years old male patients presented with peripheral neuropathy. Results of electrophysiological studies were normal. Immunpanel examination was detected elevated tissue Transglutaminase antibodies levels. Duodenal biopsy revealed villous atrophy. Patient was started on strict gluten free diet and one year later he had almost complete recovery. 46-years-old male diagnosed with Dermatitis herpetiformis Duhring and celiac disease 20-years ago. In the last few years in spite of the gluten-free diet, he newly presented intestinal symptoms and chronic iron deficiency anaemia. The control tissue Transglutaminase antibodies, and duodenal biopsies were negative. Colonoscopy found inflammation in terminal ileum; video capsule endoscopy detected multiple ulcerative lesions in whole small bowel. The results confirmed the diagnosis of Crohn’s disease. A 22-years old female patient diagnosed with celiac disease during the puerperium. The patient had muscles weakness, swallowing dysfunction, diplopia and generalized fatigue too. Muscle biopsies were normal. The electromyography was specific to myasthenia gravis. Computed tomography found thymus persistent. After tymectomy she showed good clinical response to immunosuppressant and cholinesterase inhibitor therapy.
Conclusion: Autoimmune disorders have often been associated with celiac disease.


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DOI: https://doi.org/10.5430/crim.v2n1p23

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Case Reports in Internal Medicine

ISSN 2332-7243(Print)  ISSN 2332-7251(Online)

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