CASE REPORTS - Gluten sensitivity masquerading as systemic lupus erythematosus

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ls of the Rheumatic Diseases 2004;63:1501-1503

© 2004 by BMJ Publishing Group Ltd & European League Against Rheumatism

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CONCISE REPORT

Gluten sensitivity masquerading as systemic lupus erythematosus

M Hadjivassiliou1, D S 2, R A Grünewald1 and M Akil3

1 Department of Neurology, The Royal Hallamshire Hospital, Sheffield, UK

2 Department of Gastroenterology, The Royal Hallamshire Hospital, Sheffield,

UK

3 Department of Rheumatology, The Royal Hallamshire Hospital, Sheffield, UK

Correspondence to:

Dr M Hadjivassiliou

Department of Clinical Neurology, The Royal Hallamshire Hospital, Glossop

Road, Sheffield S10 2JF, UK; m.hadjivassiliou@...

Accepted 2 February 2004

ABSTRACT

Case reports: Three patients are described whose original presentation and

immunological profile led to the erroneous diagnosis of systemic lupus

erythematosus. The correct diagnosis of gluten sensitivity was made after

years of treatment with steroids and other immunosuppressive drugs.

Conclusions: The immunological profile of IgA deficiency and/or raised

double stranded DNA in the absence of antinuclear factor together with

raised inflammatory markers and symptoms suggestive of an immune diathesis

should alert the physician to the possibility of gluten sensitivity. The

presence of an enteropathy is no longer a prerequisite for the diagnosis of

gluten sensitivity, which can solely present with extraintestinal symptoms

and signs. Knowledge of the diverse manifestations of gluten sensitivity is

essential in avoiding such misdiagnosis.

Full text:

http://ard.bmj.com/cgi/content/full/63/11/1501

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