Abstract
We describe three cases of osteomalacia presenting in Tunisian women, all of whom had previously-undiagnosed cœliac disease (CD). Direct enquiry revealed an important weight loss and a history of diarrhoea in two patients, and a 15-year history of anaemia in one patient. Laboratory tests showed severe anaemia in the three cases. Reduced calcium was found in two cases, and corrected calcium was found in one case. Radiological examination showed fissure in two cases. The diagnosis of osteomalacia was made by clinical, biochemical and radiological features. Antigliadin, antireticulin, antiendomysial and anti-tissue transglutaminase antibodies were all positive in the three cases, and a small-bowel biopsy confirmed the diagnosis of CD. Treatment with gluten-free diet (GFD), supplemental calcium and vitamin D was initiated for the three patients, but only one patient complies strictly with the GFD; she showed a marked resolution of her symptoms.
Abbreviations
- AEA:
-
Antiendomysial antibodies
- AGA:
-
Antigliadin antibodies
- ARA:
-
Antireticulin antibodies
- AtTGA:
-
Anti-tissue transglutaminase antibodies
- BMD:
-
Bone mineral density
- CD:
-
Cœliac disease
- GFD:
-
Gluten-free diet
- IEL:
-
Increased intraepithelial lymphocytes
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Landolsi, H., Bouajina, E., Mankaï, A. et al. Severe osteomalacia due to undiagnosed cœliac disease: three case reports of Tunisian women. Rheumatol Int 26, 261–263 (2006). https://doi.org/10.1007/s00296-005-0618-6
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DOI: https://doi.org/10.1007/s00296-005-0618-6