Isolated polyarthritis revealing celiac disease: A case report

Nonclassical celiac disease is a diagnostic challenge for the practitioner. We report a case of a 28-year-old Moroccan woman who had been experiencing polyarthralgia and joint swelling for 8 weeks, despite treatment with nonsteroidal anti-inflammatory drugs and corticosteroids. On physical examinati...

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Main Authors: Ahmed Mougui, Imane El Bouchti
Format: Article
Language:English
Published: SAGE Publishing 2023-07-01
Series:SAGE Open Medical Case Reports
Online Access:https://doi.org/10.1177/2050313X231186305
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author Ahmed Mougui
Imane El Bouchti
author_facet Ahmed Mougui
Imane El Bouchti
author_sort Ahmed Mougui
collection DOAJ
description Nonclassical celiac disease is a diagnostic challenge for the practitioner. We report a case of a 28-year-old Moroccan woman who had been experiencing polyarthralgia and joint swelling for 8 weeks, despite treatment with nonsteroidal anti-inflammatory drugs and corticosteroids. On physical examination, there was effusion in the proximal interphalangeal joints, metacarpophalangeal joints, wrists, knees, and ankles. Laboratory tests revealed microcytic anemia, elevated levels of inflammation markers, low ferritin, and a low vitamin D level. An upper gastrointestinal endoscopy was performed to investigate the cause of anemia, revealing the loss of duodenal folds. Subsequently, a duodenal biopsy was performed, and serological testing for celiac disease was requested. Anti-transglutaminase-2 antibodies were elevated at 200 U/ml (normal < 15U/ml). The duodenal biopsy showed flattened duodenal mucosal epithelium. The patient was diagnosed with celiac disease. A gluten-free diet was started. Her joint symptoms resolved in 3 weeks. All blood tests returned to normal levels after 48 weeks. This case illustrates that celiac disease should be considered in cases of arthritis with an initial negative etiological workup.
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spelling doaj.art-bf988dfd0efe4d6a9b421d552af6554f2023-07-08T09:03:20ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2023-07-011110.1177/2050313X231186305Isolated polyarthritis revealing celiac disease: A case reportAhmed MouguiImane El BouchtiNonclassical celiac disease is a diagnostic challenge for the practitioner. We report a case of a 28-year-old Moroccan woman who had been experiencing polyarthralgia and joint swelling for 8 weeks, despite treatment with nonsteroidal anti-inflammatory drugs and corticosteroids. On physical examination, there was effusion in the proximal interphalangeal joints, metacarpophalangeal joints, wrists, knees, and ankles. Laboratory tests revealed microcytic anemia, elevated levels of inflammation markers, low ferritin, and a low vitamin D level. An upper gastrointestinal endoscopy was performed to investigate the cause of anemia, revealing the loss of duodenal folds. Subsequently, a duodenal biopsy was performed, and serological testing for celiac disease was requested. Anti-transglutaminase-2 antibodies were elevated at 200 U/ml (normal < 15U/ml). The duodenal biopsy showed flattened duodenal mucosal epithelium. The patient was diagnosed with celiac disease. A gluten-free diet was started. Her joint symptoms resolved in 3 weeks. All blood tests returned to normal levels after 48 weeks. This case illustrates that celiac disease should be considered in cases of arthritis with an initial negative etiological workup.https://doi.org/10.1177/2050313X231186305
spellingShingle Ahmed Mougui
Imane El Bouchti
Isolated polyarthritis revealing celiac disease: A case report
SAGE Open Medical Case Reports
title Isolated polyarthritis revealing celiac disease: A case report
title_full Isolated polyarthritis revealing celiac disease: A case report
title_fullStr Isolated polyarthritis revealing celiac disease: A case report
title_full_unstemmed Isolated polyarthritis revealing celiac disease: A case report
title_short Isolated polyarthritis revealing celiac disease: A case report
title_sort isolated polyarthritis revealing celiac disease a case report
url https://doi.org/10.1177/2050313X231186305
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