Skip to main content

Advertisement

SpringerLink
Log in

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

  • Case Report
  • Published:
Rheumatology International Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Lightfoot RW, Michel BAM, Bloch DA, Hunder GG, Zvaifler NJ, McShane DJ, Arend WP, Calabrese LH, Leavitt RY, Lie JT, Masi AT, Mills JA, Stevens MB, Wallace SL (1990) The American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa. Arthritis Rheum 33:1088–1093

    PubMed  Google Scholar 

  2. Trepo C, Guillevin L (2001) Polyarteritis nodosa and extraepatic manifestation of HBV infection: the case against autoimmune intervention in pathogenesis. J Autoimmun 16:269–274. doi:10.1006/jaut.2000.0502

    Article  PubMed  CAS  Google Scholar 

  3. Green Peter HR, Jabri B (2003) Coeliac disease. Lancet 362:383–391. doi:10.1016/S0140-6736(03)14027-5

    Article  PubMed  CAS  Google Scholar 

  4. Chin RL, Sander HW, Brannagan TH, Green PH, Hays AP, Alaedini A, Latov N (2003) Celiac neuropathy. Neurology 60:1581–1585

    PubMed  CAS  Google Scholar 

  5. Hadjivassiliou M, Grϋnewald LA, Chattopadhyay AK, Davies-Jones GA, Gibson A, Jarrett JA (1998) Clinical, radiological, neurophysiological and neuropathological characteristics of gluten ataxia. Lancet 352:1582–1585. doi:10.1016/S0140-6736(98)05342-2

    Article  PubMed  CAS  Google Scholar 

  6. Beyenburg S, Scheid B, Deckert-Schlϋter M, Lagrèze HM (1998) Chronic progressive leukoencephalopathy in adult celiac disease. Neurology 50:820–822

    PubMed  CAS  Google Scholar 

  7. Chinnery PF, Reading PJ, Milne D, Gardner-Medwin D, Turnbull DM (1997) CSF antigliadin antibodies and the Ramsay Hunt syndrome. Neurology 49:1131–1133

    PubMed  CAS  Google Scholar 

  8. Mumford CJ, Fletcher NA, Ironside JW, Warlow CP (1996) Progressive ataxia, focal seizures, and malabsorption syndrome in a 41-year-old woman. J Neurol Neurosurg Psychiatry 60:225–230

    Article  PubMed  CAS  Google Scholar 

  9. Volta U, De Giorgio R, Petrolini N, Stanghellini V, Barbera G, Granito A, De Ponti F, Corinaldesi B, Bianchi FB (2002) Clinical finding and anti-neuronal antibodies in coeliac disease with neurological disorders. Scand J Gastroenterol 37:1276–1281. doi:10.1080/003655202761020542

    Article  PubMed  CAS  Google Scholar 

  10. Ventura A (1998) Coeliac disease and autoimmunity. In: Lohiniemi S, Collin P, Maki M (eds) Changing features of coeliac disease. The Finnish Coeliac Society, Tampere, pp 67–72

  11. Sategna Guidetti C, Solerio E, Scaglione N, Aimo G, Mengozzi G (2001) Duration of gluten exposure in adult celiac disease does not correlate with the risk for autoimmune disorders. Gut 49:502–505. doi:10.1136/gut.49.4.502

    Article  PubMed  CAS  Google Scholar 

  12. Toscano V, Conti FG, Anastasi E, Mariani P, Tiberti C, Poggi M, Montuori M, Monti S, Laurenti S, Cipolletta E, Gemme G, Caiola S, Di Mario U, Bonamico M (2000) Importance of gluten in the induction of endocrine autoantibodies and organ dysfunction in adolescent celiac patients. Am J Gastroenterol 95:1742–1748. doi:10.1111/j.1572-0241.2000.02187.x

    Article  PubMed  CAS  Google Scholar 

  13. Kumar V, Rajadhyaksha M, Wortsman J (2001) Celiac disease-associated autoimmune endocrinopathies. Clin Diagn Lab Immunol 8:678–685. doi:10.1128/CDLI.8.4.678-685.2001

    Article  PubMed  CAS  Google Scholar 

  14. Frustaci A, Cuoco L, Chimenti C, Pieroni M, Fioravanti G, Gentiloni N, Maseri A, Gasbarrini G (2002) Celiac disease associated with autoimmune myocarditis. Circulation 105:2611–2618. doi:10.1161/01.CIR.0000017880.86166.87

    Article  PubMed  Google Scholar 

  15. Kelkar P, Ross MA, Murray J (1996) Mononeuropathy multiplex associated with celiac sprue. Muscle Nerve 19:234–236. doi:10.1002/(SICI)1097-4598(199602)19:2<234::AID-MUS19>3.0.CO;2-U

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurological Sciences, Section of Clinical Neurology, University of Verona, Verona, Italy

    Giovanna Squintani, Sergio Ferrari, Tiziana Cavallaro, Nicola Refatti, Nicola Rizzuto & Paola Tonin

  2. Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy

    Paola Caramaschi

  3. Istituto Medicina Interna B, Policlinico G.B. Rossi, P.le Scuro, 37134, Verona, Italy

    Paola Caramaschi

Authors
  1. Giovanna Squintani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sergio Ferrari
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paola Caramaschi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tiziana Cavallaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nicola Refatti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nicola Rizzuto
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Paola Tonin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paola Caramaschi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Squintani, G., Ferrari, S., Caramaschi, P. et al. Multineuropathy in a patient with HBV infection, polyarteritis nodosa and celiac disease. Rheumatol Int 29, 579–581 (2009). https://doi.org/10.1007/s00296-008-0704-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-008-0704-7

Keywords

Search

Navigation