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[伴有枕部钙化的乳糜泻:2例晚期病例]

[Celiac disease with occipital calcifications: 2 late cases].

作者信息

Baquero M, Narciso M L, García M, Perla C, Domínguez F

机构信息

Servicio de Neurología, Hospital Universitari La Fe, Valencia.

出版信息

Med Clin (Barc). 1995 Dec 8;105(20):781-3.

PMID:8558980
Abstract

The association of celiac disease, epilepsy and occipital calcifications with initial clinical manifestations of epilepsy during the first two decades of life with an often progressive and variable course and clinical expression of malabsorption has recently been described. Two cases of celiac disease with occipital calcifications and a presentation with neurologic symptoms in adulthood are reported. The first case is that of a 40-year-old male who presented recurrent and alternating pure brachial monoparesis and later acute abdominal pain following which celiac sprue was diagnosed. The second case is that of a 53-year-old woman diagnosed with celiac sprue 20 years before, presenting permanent myoclonus in the lower limbs which were progressive in severity, ataxic march and generalized tonoclonic seizures. Both patients had bilateral occipital calcifications on CT and celiac disease was demonstrated on biopsy. The first case also showed marked signal alteration in the white matter on MRI. Celiac disease with cerebral calcifications presents also in adulthood with atypical clinical manifestations. Suspicion of celiac disease may be confirmed by non-invasive methods such as antigliadin and antiendomysium antibody determination. CT imaging is characteristic.

摘要

乳糜泻、癫痫和枕骨钙化与生命最初二十年癫痫的初始临床表现相关,其病程通常呈进行性且多变,并伴有吸收不良的临床表现,这一点最近已有描述。本文报告了两例伴有枕骨钙化的乳糜泻病例,且均在成年期出现神经症状。第一例为一名40岁男性,表现为反复交替出现的单纯臂部单瘫,随后出现急性腹痛,之后被诊断为乳糜泻。第二例是一名53岁女性,20年前被诊断为乳糜泻,目前表现为下肢永久性肌阵挛,且症状逐渐加重,伴有共济失调步态和全身性强直阵挛发作。两名患者CT检查均显示双侧枕骨钙化,活检证实患有乳糜泻。第一例患者MRI检查还显示白质有明显信号改变。伴有脑钙化的乳糜泻在成年期也可表现为非典型临床表现。通过抗麦胶蛋白和抗肌内膜抗体测定等非侵入性方法可确诊乳糜泻。CT成像具有特征性。

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