Pagine elettroniche ; Caso Contributivo
Il rischio di andare alla deriva sull'iceberg della celiachia
POSSIBLE PITFALLS IN DIAGNOSING CELIAC DISEASE
M. Fornaro, R. Gaudino1, L. Balanzoni, C. Bortoluzzi, S. Conte1, E. Valletta1,
Scuola di Specializzazione in Pediatria, 1Clinica Pediatrica Università di Verona
Febbraio 2009 - pagg. 124 -125
Abstract
A 12-year old child with failure-to-thrive had diagnosis
of celiac disease at the age of 20 months, in spite of
negative serologic markers and only slight histological modifications
at the duodenal biopsy. After 10 years of gluten free
diet his weight and height were ≤ 2 SD than the normal values
for the age. He had also neurodevelopmental delay, dyslexia
and visual disturbances. Markers of HLA susceptibility
for celiac disease were absent. Investigations showed growth
hormone deficiency and neuromuscular impairment due to
mitochondrial encephaloneuromyopathy (cytochrome c-oxidase
deficiency). Possible pitfalls in diagnosing celiac disease
are discussed. Clinical history, serology, histology and
gluten-dependency must be taken in account especially in
doubtful clinical situations.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Corrispondenza: enrico.valletta@azosp.vr.it