Corvaglia L, Catamo R, Pepe G, Lazzari R, Corvaglia E
Department of Pediatric Gastroenterology, St. Orsola Hospital, University of Bologna, Italy.
Am J Gastroenterol. 1999 Mar;94(3):839-43. doi: 10.1111/j.1572-0241.1999.00956.x.
Untreated celiac disease can lead to serious behavioral disorders. We describe three adult patients with undiagnosed or untreated celiac disease without particular intestinal signs, causing persistent depressive symptoms in three of the parents of our pediatric patients. In two of the three cases, the pediatrician suspected the diagnosis when taking the family history of the children. In fact, a diagnosis of celiac disease was made during childhood, when they had intestinal symptoms, but the gluten-free diet was spontaneously interrupted during the teenage period because of the disappearance of the typical intestinal signs. In the third case the mother was tested for antiendomysium antibodies (EmA), as she had a diagnosed celiac child. In all three patients, the depressive symptoms improved quickly with a gluten-free diet. In conclusion, celiac disease should be taken into consideration in the presence of behavioral and depressive disorders, particularly if they are not responsive to the usual antidepressive therapy.
未经治疗的乳糜泻可导致严重的行为障碍。我们描述了三名成年患者,他们患有未确诊或未治疗的乳糜泻,没有特殊的肠道症状,却在我们儿科患者的三位家长中引发了持续的抑郁症状。在这三个案例中的两个,儿科医生在询问孩子家族病史时怀疑了诊断。事实上,他们在童年时期出现肠道症状时被诊断为乳糜泻,但由于典型肠道症状消失,在青少年时期自发中断了无麸质饮食。在第三个案例中,母亲因有一个被诊断为乳糜泻的孩子而接受了抗肌内膜抗体(EmA)检测。在所有三名患者中,无麸质饮食使抑郁症状迅速改善。总之,在出现行为和抑郁障碍时应考虑乳糜泻,特别是如果这些症状对常规抗抑郁治疗无反应时。