Nunes Gonçalo, Barosa Rita, Patita Marta, Fernandes Vítor, Gonçalves Diogo, Fonseca Jorge
Department of Gastroenterology, Almada, Portugal.
Department of Pathology, Hospital Garcia de Orta, Almada, Portugal.
GE Port J Gastroenterol. 2017 Nov;24(6):292-295. doi: 10.1159/000461593. Epub 2017 Mar 24.
Celiac disease (CD) is a chronic immune-mediated enteropathy driven by gluten and affecting individuals of all ages. The diagnosis of CD in adulthood is emerging and patients often present with nonclassical extraintestinal manifestations. We report the case of a 53-year-old man presenting with neuromuscular symptoms, skin rash, inconspicuous chronic diarrhea, marked weight loss, and biochemical markers of malabsorption. A strong clinical suspicion led to the diagnosis of CD with clinical recovery after the initiation of a gluten-free diet. Clinical presentation with atypical symptoms in adult CD patients is the rule and not the exception. Most of the extraintestinal manifestations depend on background autoimmune phenomena and micronutrient malabsorption. A gluten-free diet re-establishes homeostasis and prevents long-term complications.
乳糜泻（CD）是一种由麸质驱动的慢性免疫介导性肠病，可影响所有年龄段的个体。成人CD的诊断正在逐渐增多，患者常表现为非典型的肠外表现。我们报告了一例53岁男性患者，其出现神经肌肉症状、皮疹、不明显的慢性腹泻、显著体重减轻以及吸收不良的生化指标。强烈的临床怀疑导致该患者被诊断为CD，在开始无麸质饮食后临床症状得以恢复。成年CD患者表现出非典型症状是常态而非例外。大多数肠外表现取决于潜在的自身免疫现象和微量营养素吸收不良。无麸质饮食可重建体内平衡并预防长期并发症。
