Hypocalcemia and skeletal disease as presenting features of celiac disease. Arch Intern Med 1997 May 12;157(9):1013-6
Date
05/12/1997Pubmed ID
9140273DOI
10.1001/archinte.157.9.1013Scopus ID
2-s2.0-0030996594 (requires institutional sign-in at Scopus site) 43 CitationsAbstract
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.
Author List
Shaker JL, Brickner RC, Findling JW, Kelly TM, Rapp R, Rizk G, Haddad JG, Schalch DS, Shenker YAuthors
James W. Findling MD Professor in the Medicine department at Medical College of WisconsinJoseph L. Shaker MD Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Bone Density
Bone Diseases, Metabolic
Celiac Disease
Diagnosis, Differential
Female
Humans
Hypocalcemia
Male
Middle Aged
