Abstract
Celiac disease is considered a malabsorption syndrome and is characterized by chronicsmall intestinal disease caused by hypersensitivity to the gliadin fraction of gluten. Celiac disease comes with diarrhea, occasional steatorrhea, weight loss, and other complications which might be caused by anemia. Reports of osteomalacia as the only symptom of celiac disease are very rare; however, osteomalacia can be a detected sign of celiac disease. Herein is described a case of osteomalaciawith a Looser zone in a 39-year-old woman who had low bone mineral density caused by severe osteomalacia associated with chronic celiac disease. In patients with pain in the spine and proximal muscle, the risk of osteomalacia should be considered in any kind of diagnosis.
Highlights
Celiac disease is an autoimmune inflammatory disease of the small intestine caused by the ingestion of gluten, a part of wheat protein, in genetically susceptible people [1]
The present article discusses a patient who was referred to the medical center with low bone mineral density due to longstanding osteomalacia with a Looser zone and celiac disease
The patient’s clinical and laboratory responses to a glutenfree diet, iron, and calcium-vitamin D were good, which is indicative of celiac disease
Summary
Celiac disease is an autoimmune inflammatory disease of the small intestine caused by the ingestion of gluten, a part of wheat protein, in genetically susceptible people [1]. The present article discusses a patient who was referred to the medical center with low bone mineral density due to longstanding osteomalacia with a Looser zone and celiac disease. A 39-year-old woman was referred to the Rheumatology Clinic in Ghaem Medical Center, Mashhad University of Medical Sciences, Mashhad, Iran, in June 2016 She complained of experiencing pain in her spine and proximal muscle for the past three years. Clinical examination indicated bilateral proximal muscle atrophy, and the patient complained of weakness in the upper and lower extremities Her hip range of motion was limited and accompanied by pain. The diagnosis of celiac disease of this patient was confirmed by positive IgA and IgG anti-gliadin, anti-tissue tranglutaminase antibody tests, endoscopic detection of inflammation, and atrophy of duodenal mucosa. The patient’s clinical and laboratory responses to a glutenfree diet, iron, and calcium-vitamin D were good, which is indicative of celiac disease
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