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Depression: 21st Century Solutions + The Dark Side of Wheat

Abstract Title:

Uveitis in celiac disease with an excellent response to gluten-free diet: third case described.

Abstract Source:

Rheumatol Int. 2011 Mar ;31(3):399-402. Epub 2009 Oct 14. PMID: 19826819

Abstract Author(s):

Karin Klack, Rosa Maria Rodrigues Pereira, Jozélio Freire de Carvalho

Article Affiliation:

Division of Nutrition, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

Abstract:

To describe the case of a patient with celiac disease who achieved a complete response to a gluten-free diet. A 28-year-old woman presented with diarrhea, oral ulcers, and refractory uveitis of 2.5-years duration. She was treated with prednisone, mydriatic drops, and infliximab with no response. She was referred to our hospital at which point her previous diagnosis of uveitis was confirmed; she was also diagnosed with right-sided sacro-iliitis. The patient did not have arthritis or any skin conditions. Three tests for fecal parasites and a fecal leukocyte were negative. Endoscopy revealed atrophic appearance of the duodenal mucosa. Biopsy showed atrophy of the duodenal villi with intra-epithelial lymphocytes, hyperplasia of the crypts, and chronic inflammatory infiltrate. The search for antiendomysial antibody was>1/1,280. The patient was started on a gluten-free diet and after 3 months demonstrated significant improvement of gastrointestinal symptoms and uveitis, as well as a reduction of antiendomysial antibodies (1/80). After 6 months, there was complete remission of gastrointestinal symptoms and total control of uveitis. The antiendomysial antibody was negative at that time. Clinical uveitis as a manifestation of celiac disease has been described in only two cases in the literature. This case study is the third to demonstrate that uveitis is a clinical symptom that can be addressed in patients with celiac disease.

Study Type : Human: Case Report

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Sayer Ji
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Depression: 21st Century Solutions + The Dark Side of Wheat

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