Multineuropathy in a patient with HBV infection, polyarteritis nodosa and celiac disease

Rheumatol Int. 2009 Mar;29(5):579-81. doi: 10.1007/s00296-008-0704-7. Epub 2008 Sep 23.

Abstract

We report on the first association of celiac disease, polyarteritis nodosa and HBV infection in a patient who developed a neuropathy. On admission his general and neurological conditions were severely compromised. Haematological test revealed HBV infection and high levels of antibodies to tissue transglutaminase, endomysium, gliadin. EMG showed sensory-motor asymmetric axonal neuropathy. A sural nerve biopsy revealed fibre loss, axonal degeneration with asymmetrical distribution and fascicular ischaemia. A duodenal biopsy was consistent with celiac disease. The patient was treated with immunosuppressive and antiviral therapy, and gluten-free diet with good result. Celiac disease can be related to a higher risk of autoimmune disorders and may have contributed to the development of multineuropathy in this patient.

Publication types

  • Case Reports

MeSH terms

  • Antibodies / immunology
  • Antiviral Agents / therapeutic use
  • Celiac Disease / complications*
  • Celiac Disease / drug therapy
  • Celiac Disease / pathology
  • Diet, Gluten-Free*
  • Gliadin / immunology
  • Hepatitis B / complications*
  • Hepatitis B / pathology
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Middle Aged
  • Polyarteritis Nodosa / complications*
  • Polyarteritis Nodosa / pathology
  • Polyneuropathies / pathology*
  • Transglutaminases / immunology
  • Treatment Outcome

Substances

  • Antibodies
  • Antiviral Agents
  • Immunosuppressive Agents
  • Gliadin
  • Transglutaminases