A case of celiac disease with neurologic manifestations misdiagnosed as amyotrophic lateral sclerosis.
- Author:
Hyoju HAM
1
;
Bo In LEE
;
Hyun Jin OH
;
Se Hwan PARK
;
Jin Su KIM
;
Jae Myung PARK
;
Young Seok CHO
;
Myung Gyu CHOI
Author Information
- Publication Type:Case Report
- Keywords: Celiac disease; Malabsorption syndromes; Amyotrophic lateral sclerosis
- MeSH: Amyotrophic Lateral Sclerosis*; Anemia; Asia; Biopsy; Bone Diseases, Metabolic; Celiac Disease*; Diagnosis; Diet, Gluten-Free; Eating; Endoscopy, Digestive System; Follow-Up Studies; Humans; Infertility; Korea; Malabsorption Syndromes; Mucous Membrane; Neurologic Manifestations*; Precipitating Factors; Rare Diseases; Triticum; Weight Loss
- From:Intestinal Research 2017;15(4):540-542
- CountryRepublic of Korea
- Language:English
- Abstract: Celiac disease (CD) is an immune-mediated enteropathy and is a rare disease in Asia, including in Korea. However, the ingestion of wheat products, which can act as a precipitating factor of CD, has increased rapidly. CD is a common cause of malabsorption, but many patients can present with various atypical manifestations as first presented symptoms, including anemia, osteopenia, infertility, and neurological symptoms. Thus, making a diagnosis is challenging. We report a case of CD that mimicked amyotrophic lateral sclerosis (ALS). The patient was a sexagenary man with a history of progressive motor weakness for 2 years. He was highly suspected as having ALS. During evaluation of his neurological symptoms, esophagogastroduodenoscopy (EGD) was performed because he had experienced loose stools and weight loss for the previous 7 months. On EGD, the duodenal mucosa appeared smooth. A biopsy revealed severe lymphoplasma cell infiltration with flattened villi. His serum endomysial antibody (immunoglobulin A) titer was 1:160 (reference, <1:40). Finally, he was diagnosed as having CD, and a gluten-free diet was immediately begun. At a 4-month follow-up, his weight and the quality of his stool had improved gradually, and the neurological manifestations had not progressed.
