Proximal Muscle Weakness--An Unusual Presentation of Celiac Disease

Jain, Vivek; Angiti, Rajeshwar Reddy; Singh, Surjit; Thapa, Babu Ram; Kumar, Lata

doi:10.1093/tropej/48.6.380

Cited by 9 publications

(9 citation statements)

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“…Vitamin D deficiency cannot be excluded as a contributing factor for the myopathy in this case, because the patient had an elevated serum alkaline phosphatase, a sensitive marker consistent with osteomalacia, despite normal serum calcium and phosphate levels. Cases of myopathy and vitamin D deficiency in celiac disease have been reported 3, 23, 44. However, besides proximal weakness, all of these patients had prominent bone pain, which was not present in our patient.…”

Section: Discussioncontrasting

confidence: 45%

Reversible inflammatory and vacuolar myopathy with vitamin E deficiency in celiac disease

et al. 2004

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We report a patient with late-onset celiac disease and neurological manifestations including myopathy, polyneuropathy, and ataxia. Laboratory investigations showed anti-gliadin antibodies and severe vitamin E deficiency. Muscle biopsy revealed inflammatory infiltrates and rimmed vacuoles, similar to those found in inclusion-body myositis. A gluten-free diet and vitamin E supplementation reversed both the clinical neurological manifestations and the abnormalities in the muscle biopsy. Anti-gliadin antibodies were no longer present. This case illustrates the spectrum of neurological complications of celiac disease and documents the occurrence of reversible pathology resembling inclusion-body myopathy in the muscle.

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Section: Discussioncontrasting

confidence: 45%

Reversible inflammatory and vacuolar myopathy with vitamin E deficiency in celiac disease

et al. 2004

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“…In children, muscle involvement due to vitamin D deficiency was reported in a 5-year-old child with cholestatic liver disease(1) and in another 11-yearold girl with celiac disease (2). In our case, vitamin D deficiency was associated with phenytoin therapy.…”

Section: From the Department Of Pediatrics University College Of Medmentioning

confidence: 51%

“…VOLUME 47 __ JULY 17, 2010 I n children, muscle weakness due to vitamin D deficiency is rarely reported (1,2). We herein report one such case.…”

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confidence: 82%

Phenytoin induced vitamin d deficiency presenting as proximal muscle weakness

Faridi

Aggarwal

2010

Indian Pediatr

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A 6-year-old girl presented with proximal muscle weakness of lower limbs. She was receiving phenytoin for epilepsy for 2 years. Serum phenytoin level was within therapeutic range. Serum 25(OH) vitamin D was low (5 ng/mL) and serum parathyroid hormone level was high. After administration of oral vitamin D, muscle weakness improved and vitamin D level increased to 39.11 ng/mL. Proximal muscle weakness due to vitamin D deficiency following phenytoin intake is rare in children.

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“…Rickets-associated myopathy was reported as the only presenting complaint of celiac disease even in a 5-year-old girl [12]. Jain et al [13] reported an 11-year-old girl who had bone pain, waddling gait, Gowers' sign, and supracondylar fracture of humerus. Anemia, short stature, and associated rickets were the other signs suggestive of a malabsorptive state.…”

Section: Discussionmentioning

confidence: 99%

“…Fortunately, the typical skeletal alterations for adult osteomalacic patients were not detected. Bone and joint pain, especially at the shoulder, rib cage, pelvic girdle, and lower back, could be observed in patients with osteomalacia [5,8,10,11,13,23,24]. Pain at hip and shoulders as well as diffuse rib cage tenderness are most useful criteria for distinguishing osteomalacia from osteoporosis [25].…”

Section: Discussionmentioning

confidence: 99%