Adhi Mehreen, Farooq Asma, Hamid Syed Ali, Hasan Rabia, Mamji Salman, Baloch Akhtar Ali
Department of Surgery, The Aga Khan University Hospital (Stadium Road), Karachi (74800), Pakistan.
Cases J. 2009 May 18;2:7512. doi: 10.1186/1757-1626-2-7512.
We report a case of sero-negative celiac disease in Pakistan.
A 20-year-old female presented with papulovesicular rash for 15 years, diarrhea for 8 years, spasms of hands and twitching of face for 4-5 months. She had mild anemia, low vitamin-D3 and serum calcium. On exclusion of other causes of malabsorption, anti-tissue transglutaminase antibodies (immunoglobulin-A & immunoglobulin-G), anti-endomysial antibodies, total immunoglobulin-A levels and skin biopsy were performed, which were normal. Intestinal biopsy revealed subtotal villous atrophy. Patient was prescribed gluten-free diet, to which she responded with alleviation of symptoms.
Negative serology should not rule out celiac disease; intestinal biopsy should be performed if there is strong clinical suspicion.
我们报告一例巴基斯坦的血清阴性乳糜泻病例。
一名20岁女性，出现丘疹水疱性皮疹15年，腹泻8年，手部痉挛和面部抽搐4 - 5个月。她有轻度贫血、低维生素D3和血清钙水平。在排除其他吸收不良原因后，检测了抗组织转谷氨酰胺酶抗体（免疫球蛋白A和免疫球蛋白G）、抗肌内膜抗体、总免疫球蛋白A水平并进行了皮肤活检，结果均正常。肠道活检显示绒毛部分萎缩。患者接受了无麸质饮食治疗，症状得到缓解。
血清学阴性不应排除乳糜泻；如果临床高度怀疑，应进行肠道活检。
