 |
|
Hypocalcemia and Skeletal Disease as Presenting Features of Celiac Disease
Joseph L. Shaker, MD;
Robert C. Brickner, MD;
James W. Findling, MD;
Thomas M. Kelly, MD;
Richard Rapp, MD;
Ghyass Rizk, MD;
John G. Haddad, MD;
Don S. Schalch, MD;
Yoram Shenker, MD
Arch Intern Med. 1997;157(9):1013-1016.
Abstract
| |
Objective
To describe 15 patients examined for hypocalcemia, skeletal disease, or both in whom the diagnosis of celiac disease was subsequently made.
Design
Observational case series.
Patients
Fifteen patients (7 women and 8 men) were examined for hypocalcemia (n=11), skeletal disease (n=3), or both (n=1). The diagnosis of celiac disease was subsequently made. The mean age of the patients was 62 years, and 11 patients were 60 years of age or older.
Results
Four patients had no gastrointestinal symptoms, 7 patients had mild or intermittent gastrointestinal symptoms, and 4 patients had persistent diarrhea. Ten patients had experienced weight loss. The serum total alkaline phosphatase level was elevated in 10 of 15 patients, the parathyroid hormone level was elevated in all patients, and the urinary calcium level was low in all 6 of the patients tested. The level of 25-hydroxyvitamin D was frankly low in 4 patients, marginal in 8 patients, and normal in 3 patients. Bone mineral density was reduced in all 8 patients in whom it was measured.
Conclusions
Celiac disease should be considered in patients with unexplained metabolic bone disease or hypocalcemia, especially because gastrointestinal symptoms may be absent or mild. Advanced age does not exclude the diagnosis of celiac disease.
Arch Intern Med. 1997;157:1013-1016
Author Affiliations
From the Department of Medicine, St Luke's Medical Center, Milwaukee, Wis (Drs Shaker, Brickner, Findling, and Rizk); the Department of Medicine, St Joseph's Hospital, Milwaukee (Dr Kelly); the Department of Medicine, St Mary's Hospital, Racine, Wis (Dr Rapp); the Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia (Dr Haddad); the Department of Medicine, University of Wisconsin School of Medicine, Madison (Drs Schalch and Shenker); and the Department of Medicine, William S. Middleton Memorial Veterans Hospital, Madison (Dr Shenker).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Hypoparathyroidism and coeliac disease: a potentially dangerous combination
Kohler and Wass
JRSM 2009;102:311-314.
FULL TEXT
Carpopedal spasm in an elderly man: an unusual presentation of coeliac disease
Schmidt et al.
JRSM 2007;100:524-525.
FULL TEXT
Celiac Disease-Associated Autoimmune Endocrinopathies
Kumar et al.
CVI 2001;8:678-685.
ABSTRACT
| FULL TEXT
|
