Lupattelli G, Fuscaldo G, Castellucci G, Ciuffetti G, Pelli M A, Mannarino E
Clinica Medica I, Università degli Studi di Perugia.
Ann Ital Med Int. 1994 Jan-Mar;9(1):40-3.
This report discusses a severe case of osteomalacia due to gluten-sensitive enteropathy: it stresses the clinical features and describes an atypical form of gluten-sensitive enteropathy, in which gastroenterological symptoms were absent. Wasting and osteomalacia causing skeletal deformation with spontaneous fractures were observed in a 31-year-old woman who had marked hypophosphoremia, a tendency to low serum calcium levels and slight multi-deficiency anaemia. The patient was in a state of depression. The causes of osteomalacia and then a general malabsorption syndrome were investigated. Anti-gliadin antibodies were positive. Histological tests on duodenal mucous revealed a pattern indicative of gluten-sensitive enteropathy. A gluten-free diet was prescribed and at a check-up one month later the patient had improved markedly. Skeletal symptoms are predominant in 30% of atypical forms of gluten-sensitive enteropathy. The severity of this case was due to a late diagnosis.
强调了临床特征，并描述了一种非典型的麸质敏感性肠病形式，其中不存在胃肠症状。在一名31岁女性中观察到消瘦和骨软化症导致骨骼变形并伴有自发性骨折，该患者有明显的低磷血症、血清钙水平偏低的倾向以及轻度多种营养素缺乏性贫血。患者处于抑郁状态。对骨软化症以及随后的一般吸收不良综合征的病因进行了调查。抗麦醇溶蛋白抗体呈阳性。十二指肠黏膜的组织学检查显示出提示麸质敏感性肠病的模式。开出了无麸质饮食的处方，一个月后的复查显示患者有明显改善。在30%的非典型麸质敏感性肠病形式中，骨骼症状占主导。该病例的严重程度归因于诊断延迟。
