Osteoporosis Can Be the Sole Presentation in Celiac Disease.

Celiac disease, an autoimmune condition causing gluten intolerance and disrupted absorption of nutrients, predisposes to osteoporosis. The release of pro-inflammatory cytokines, calcium malabsorption, and the activation of osteoclasts represent the main mechanisms responsible for bone derangement. This is evidenced by the low T-score on dual-energy x-ray absorptiometry (DXA) scans in these patients. However, these changes are reversible with the early initiation of a gluten-free diet. Hence, it is important for physicians to consider screening for celiac disease panel in patients presenting with osteoporotic features with no clear etiology.