Celiac disease with cerebral and peripheral nerve involvement mimicking multiple sclerosis

J Med Life. 2014 Sep 15;7(3):440-4. Epub 2014 Sep 25.

Abstract

Objectives: Due to the similarity in the clinical presentation, morphology, and course, celiac disease (CD) may be mixed up with other immunological disorders, such as multiple sclerosis (MS).

Case report: In a 43-year-old Caucasian male with a history of diarrhea and colics since young age, progressive sensory disturbances developed since age 18 years. At age 34, he was diagnosed as relapsing-remitting MS upon an inflammatory CSF-syndrome and non-specific white matter lesions and treated with interferon beta-1b during the next 8 years without effect. At age 35, axonal polyneuropathy and ataxia were diagnosed. Despite normal anti-gliadin, endomysial, and transglutaminase antibodies, CD was diagnosed at age 41, based upon the history, polyneuropathy, positivity for HLA-DQ2 and HLA-DQ8, the white matter lesions, and a beneficial response of the gastrointestinal problems and polyneuropathy to gluten-free diet.

Conclusions: CD may mimic MS and may be present despite the absence of anti-gliadin, endomysial or transglutaminase antibodies. CD should be considered if there is a gastrointestinal problem, polyneuropathy, and ataxia, even if CSF and MRI findings are suggestive of MS.

Keywords: autoantibodies; immunology; immunosuppression; interferon; nerve conduction.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Celiac Disease / diagnosis*
  • Celiac Disease / diet therapy
  • Celiac Disease / pathology*
  • Cerebrum / pathology*
  • Diagnosis, Differential
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Multiple Sclerosis / diagnosis*
  • Neural Conduction / physiology
  • Peripheral Nerves / pathology*