Landolsi Hanène, Bouajina Elyès, Mankaï Amani, Zeglaoui Hela, Skandrani Karim, Ghedira Ibtissem
Laboratory of Immunology, Farhat Hached Hospital, Rue Ibn El Jazzar, 4000, Sousse, Tunisia.
Rheumatol Int. 2006 Jan;26(3):261-3. doi: 10.1007/s00296-005-0618-6. Epub 2005 Jun 24.
We describe three cases of osteomalacia presenting in Tunisian women, all of whom had previously-undiagnosed coeliac disease (CD). Direct enquiry revealed an important weight loss and a history of diarrhoea in two patients, and a 15-year history of anaemia in one patient. Laboratory tests showed severe anaemia in the three cases. Reduced calcium was found in two cases, and corrected calcium was found in one case. Radiological examination showed fissure in two cases. The diagnosis of osteomalacia was made by clinical, biochemical and radiological features. Antigliadin, antireticulin, antiendomysial and anti-tissue transglutaminase antibodies were all positive in the three cases, and a small-bowel biopsy confirmed the diagnosis of CD. Treatment with gluten-free diet (GFD), supplemental calcium and vitamin D was initiated for the three patients, but only one patient complies strictly with the GFD; she showed a marked resolution of her symptoms.
我们描述了3例突尼斯女性出现骨软化症的病例，她们均患有先前未确诊的乳糜泻（CD）。直接询问发现，2例患者有明显体重减轻及腹泻史，1例患者有15年贫血史。实验室检查显示，3例患者均有严重贫血。2例患者血钙降低，1例患者校正血钙降低。影像学检查显示2例有骨小梁稀疏。根据临床、生化及影像学特征确诊为骨软化症。3例患者的抗麦醇溶蛋白、抗网硬蛋白、抗肌内膜及抗组织转谷氨酰胺酶抗体均为阳性，小肠活检确诊为CD。3例患者均开始采用无麸质饮食（GFD）、补充钙剂及维生素D进行治疗，但只有1例患者严格遵守GFD；她的症状明显缓解。
