Tahiri Latifa, Azzouzi Hamida, Squalli Ghita, Abourazzak Fatimazahra, Harzy Taoufik
Department of Rheumatology, CHU Hassan II, Fès, Morocco.
Pan Afr Med J. 2014 Sep 19;19:43. doi: 10.11604/pamj.2014.19.43.2757. eCollection 2014.
Celiac disease (CD), a malabsorption syndrome caused by hypersensitivity to gliadin fraction of gluten. CD can manifest with classic symptoms; however, significant myopathy and multiple fractures are rarely the predominant presentation of untreated celiac disease. Osteomalacia complicating celiac disease had become more and more rare. We describe here a case of osteomalacia secondary to a longstanding untreated celiac disease. This patient complained about progressive bone and muscular pain, weakness, fractures and skeletal deformities. Radiological and laboratory findings were all in favor of severe osteomalacia. Improvement of patient's weakness and laboratory abnormalities was obvious after treatment with gluten free diet, vitamin D, calcium and iron. This case affirms that chronic untreated celiac disease, can lead to an important bone loss and irreversible complications like skeletal deformities.
乳糜泻(CD)是一种由对麸质中麦醇溶蛋白成分过敏引起的吸收不良综合征。CD可表现出典型症状;然而,严重的肌病和多处骨折很少是未经治疗的乳糜泻的主要表现。并发乳糜泻的骨软化症已越来越罕见。我们在此描述一例长期未经治疗的乳糜泻继发骨软化症的病例。该患者主诉进行性骨痛和肌肉疼痛、无力、骨折及骨骼畸形。放射学和实验室检查结果均支持严重骨软化症。采用无麸质饮食、维生素D、钙和铁治疗后,患者的无力症状及实验室异常情况明显改善。该病例证实,长期未经治疗的乳糜泻可导致严重的骨质流失及骨骼畸形等不可逆转的并发症。