De Santis A, Addolorato G, Romito A, Caputo S, Giordano A, Gambassi G, Taranto C, Manna R, Gasbarrini G
Department of Internal Medicine, Catholic University, Rome, Italy.
J Intern Med. 1997 Nov;242(5):421-3. doi: 10.1046/j.1365-2796.1997.00200.x.
A 33-year-old patient, with pre-existing diagnosis of 'schizophrenic' disorder, came to our observation for severe diarrhoea and weight loss. Use of single photon emission computed tomography, (99mTc)HMPAO SPECT, demonstrated hypoperfusion of the left frontal brain area, without evidence of structural cerebral abnormalities. Jejunal biopsy showed villous atrophy. Antiendomysial antibodies were present. A gluten-free diet was started, resulting in a disappearence of psychiatric symptoms, and normalization of histological duodenal findings and of (99mTc)HMPAO SPECT pattern. This is the first case in which, in an undiagnosed and untreated coeliac patient with psychiatric manifestations, the (99mTc)HMPAO SPECT demonstrated a dysfunction of frontal cortex disappearing after a gluten-free diet.
一名33岁的患者，先前被诊断为“精神分裂症”，因严重腹泻和体重减轻前来我们处就诊。使用单光子发射计算机断层扫描（99mTc）HMPAO SPECT显示左额叶脑区灌注不足，无脑部结构异常证据。空肠活检显示绒毛萎缩。存在抗肌内膜抗体。开始无麸质饮食，结果精神症状消失，十二指肠组织学检查结果和（99mTc）HMPAO SPECT模式恢复正常。这是首例在未诊断和未治疗的患有精神症状的乳糜泻患者中，（99mTc）HMPAO SPECT显示额叶皮质功能障碍在无麸质饮食后消失的病例。
