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

Rheumatol Int. 2011 Mar;31(3):399-402. doi: 10.1007/s00296-009-1177-z. Epub 2009 Oct 14.

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.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Celiac Disease / complications
  • Celiac Disease / diet therapy*
  • Celiac Disease / pathology
  • Diet, Gluten-Free*
  • Duodenum / pathology
  • Female
  • Humans
  • Intestinal Mucosa / pathology
  • Treatment Outcome
  • Uveitis / complications
  • Uveitis / diet therapy*
  • Uveitis / pathology