Nasal septal perforation in a patient with subclinical celiac disease: a possible new association

  • A. Medina-Banegas
  • F. A. Pastor-Quirante
  • J. Osete-Albaladejo
  • E. López-Meseguer
  • F. López-Andreu
Rhinology

Abstract

A female patient presented with nasal septal perforation that did not respond to conventional therapeutic management. Later, because of a malabsorption problem in one of her children, she underwent analytic tests and distal duodenal biopsy, which revealed that she was suffering from subclinical/silent celiac disease. The treatment, a gluten-free diet, unexpectedly resulted in the cessation of the destructive nasal process. Four years later, the patient remains asymptomatic. Nasal septal perforation might constitute a new entity associated with celiac disease hitherto not described in the literature.

Keywords

Celiac disease Malabsorptive syndrome Septal nasal perforation 

References

  1. 1.
    Otley C, Hall RP (1990) Dermatitis herpetiformis. Dermatol Clin 8:759–769PubMedGoogle Scholar
  2. 2.
    Hall RP, Smith AD, Streilein RD (2000) Increased production of IL-4 by gut T-cell lines from patients with dermatitis herpetiformis compared to patients with isolated gluten-sensitive enteropathy. Dig Dis Sci 45:2036–2043CrossRefPubMedGoogle Scholar
  3. 3.
    Bottaro G, Cataldo F, Rotolo N, Spina M, Corazza GR (1999) The clinical pattern of subclinical/silent celiac disease: an analysis of 1,026 consecutive cases. Am J Gastroenterol 94:691–696PubMedGoogle Scholar
  4. 4.
    Tursi A, Giorgetti G, Brandimarte G, Rubino E, Lombardi D, Gasbarrini G (2001) Prevalence and clinical presentation of subclinical/silent celiac disease in adults: an analysis of a 12-year observation. Hepatogastroenterology 48:462–464PubMedGoogle Scholar
  5. 5.
    Kumar V, Rajadhyaksha M, Wortsman J (2001) Celiac disease-associated autoimmune endocrinopathies. Clin Diagn Lab Immunol 8:678–685CrossRefPubMedGoogle Scholar
  6. 6.
    Diamantopoulos II, Jones NS (2001) The investigation of nasal septal perforations and ulcers. J Laryngol Otol 115:541–544CrossRefPubMedGoogle Scholar
  7. 7.
    Thompson LD, Heffner DK (2001) Sinonasal tract eosinophilic angiocentric fibrosis. A report of three cases. Am J Clin Pathol 115:243–248CrossRefPubMedGoogle Scholar
  8. 8.
    Langford CA (2001) Wegener granulomatosis. Am J Med Sci 32:76–82CrossRefGoogle Scholar
  9. 9.
    Abbondanzo SL, Wenig BM (1995) Non-Hodgkin’s lymphoma of the sinonasal tract. A clinicopathologic and immunophenotypic study of 120 cases. Cancer 75:1281–1291PubMedGoogle Scholar
  10. 10.
    Davison SP, Habermann TM, Strickler JG, DeRemee RA, Earle JD, McDonald TJ (1996) Nasal and nasopharyngeal angiocentric T-cell lymphomas. Laryngoscope 106:139–143CrossRefPubMedGoogle Scholar
  11. 11.
    Smith I, Smith M, Mathias D, Wallis J (1996) Cryoglobulinaemia and septal perforation: a rare but logical cause. J Laryngol Otol 110:668–669PubMedGoogle Scholar
  12. 12.
    Baum ED, Boudousquie AC, Li S, Mirza N (1998) Sarcoidosis with nasal obstruction and septal perforation. Ear Nose Throat J 77:896–988, 900–902PubMedGoogle Scholar
  13. 13.
    Pardo-Mindan FJ, Lozano MD, Contreras-Mejuto F, de Alava E (1992) Pathology of heart transplant through endomyocardial biopsy. Semin Diagn Pathol 9:238–248PubMedGoogle Scholar
  14. 14.
    Lu CY, Sicher SC, Vázquez MA (1993) Prevention and treatment of renal allograft rejection: new therapeutic approaches and new insights into established therapies. J Am Soc Nephrol 4:1239–1256PubMedGoogle Scholar
  15. 15.
    Murray JA (1999) The widening spectrum of celiac disease. Am J Clin Nutr 69:354–365PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • A. Medina-Banegas
    • 1
  • F. A. Pastor-Quirante
    • 2
  • J. Osete-Albaladejo
    • 1
  • E. López-Meseguer
    • 1
  • F. López-Andreu
    • 3
  1. 1.Servicio de OtorrinolaringologíaHospital General UniversitarioMurciaSpain
  2. 2.Servicio de Anatomía PatológicaHospital General UniversitarioMurciaSpain
  3. 3.Servicio de Medicina InternaHospital General UniversitarioMurciaSpain

Personalised recommendations