Ravindra B S, Desai N, Deviprasad S, Bhede V, Ravat S, Sawant P
Department of Gastroenterology, Lokmanya Tilak Medical College & Hospital, Mumbai, India.
Trop Gastroenterol. 2008 Apr-Jun;29(2):114-5.
Celiac disease (CD) has long been known to be associated with neurological and psychiatric manifestations; its in association with myotonic dystrophy however has not yet been reported. We report the case of a 27-year old female patient who presented to us with diarrhoea, weight loss, easy fatigability, irritability and alopecia of 8 months duration and was diagnosed to have celiac disease and put on gluten free diet. 8 weeks later she developed neurological symptoms and was found to have myotoni dystrophy in addition. At six month follow up patient had gained 5 kg, but the neurological symptoms remained the same. Treatment of neurological symptoms associated with gluten hypersensitivity depends on the type of neurological syndrome associated. Only exceptionally do these symptoms improve with gluten restriction and, in some patients, the neurological manifestations even progress despite resolution of both pathologic findings and intestinal symptoms.
长期以来，人们一直认为乳糜泻（CD）与神经和精神表现有关；然而，其与强直性肌营养不良的关联尚未见报道。我们报告了一例27岁女性患者，她因腹泻、体重减轻、易疲劳、易怒和脱发8个月前来就诊，被诊断为乳糜泻并开始无麸质饮食。8周后，她出现了神经症状，此外还被发现患有强直性肌营养不良。在6个月的随访中，患者体重增加了5公斤，但神经症状依然存在。与麸质过敏相关的神经症状的治疗取决于相关神经综合征的类型。这些症状仅在极少数情况下会随着麸质限制而改善，而且在一些患者中，尽管病理表现和肠道症状都已缓解，但神经表现仍会进展。
