CASE REPORTS - Gluten sensitivity masquerading as SLE

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

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

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.

http://ard.bmjjournals.com/cgi/content/abstract/63/11/1501

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Mayo Clinic in Rochester

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s Hopkins Medicine

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