Clinical Case Database / Category: Patient Management
Dr Padmini Gopalan MBBS (MRCP), Dr Steven Yeomans MRCP
Foundation Years Journal, volume 4, issue 3, p.5 (123Doc Education, London, March 2010)
The immunological response to ingested gluten in genetically susceptible individuals was first described by Marsh in 1995. Although gluten-induced enteropathy (coeliac disease) is the commonly recognised presentation, isolated neurological dysfunction, especially ataxia, has been well documented. We present a patient who had established coeliac disease and had been fully treated with no enteropathy for 10 years. After so many years of being symptom-free, the patient presented with ataxia. In the absence of any other cause, the ataxia was thought to be related to gluten sensitivity, which was proven through laboratory and radiological investigations. The case is interesting due to the way it presented as ataxia after several years and the absence of any associated gastrointestinal symptoms from coeliac disease.
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Dr Padmini Gopalan MBBS (MRCP)
ST1 in General Medicine
Doncaster Royal Infirmary
Doncaster DN2 5LT
Dr Steven Yeomans MRCP
University Hospital North Tees
Stockton-on-Tees TS19 8PE
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About the Clinical Cases Database
The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.