Mononeuropathy multiplex associated with celiac sprue

✍ Scribed by Praful Kelkar; Mark A. Ross; Joseph Murray

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 272 KB
• Volume: 19
• Category: Article
• ISSN: 0148-639X
• DOI: 10.1002/(sici)1097-4598(199602)19:2<234::aid-mus19>3.0.co;2-u

✦ Synopsis

A patient with celiac sprue developed clinical and electrophysiological features suggesting mononeuropathy multiplex, with evidence of perivascular and perineural lymphocytic infiltration on muscle biopsy. Her gluten enteropathy was well controlled with dietary gluten restrictions, and serum levels of vitamin BIZ, E, and folic acid were normal. There was no clinical or laboratory evidence of systemic vasculitis. She improved rapidly with oral prednisone with nearly complete resolution of motor deficits. Celiac sprue has been associated with a variety of neuromuscular disorders including distal axonal polyneuropathy and myopathy. This is the first report of mononeuropathy multiplex occurring in the setting of celiac sprue.

CASE REPORT

A 47-year-old Caucasian woman presented 4 weeks after sudden onset of left wrist drop while typing, with intermittent tingling over the dorsum of the left thumb. She also reported mild difficulty writing with her right hand for 2 weeks. She had been diagnosed with celiac sprue 4 years previously after evaluation of diarrhea and lactose intolerance. Biopsy of the small intestine demonstrated subtotal villous atrophy, crypt hyperplasia, intraepithelial lymphocytosis, and inflammation of lamina propria. The diagnosis of celiac sprue was confirmed by resolution of the gastrointestinal symptoms and improvement in the intestinal pathology following institution of a gluten free diet.