Atypical presentation of coeliac disease

doi:10.1136/bmj.330.7494.773

BMJ 2005;330:773-774 (2 April), doi:10.1136/bmj.330.7494.773

Clinical review

Lesson of the week

Atypical presentation of coeliac disease

R M Furse, locum specialist registrar¹, A S Mee, consultant gastroenterologist¹

¹ Department of Gastroenterology, Royal Berkshire Hospital, Reading RG1 5AN

Correspondence to: A S Mee anthony.mee@rbbh-tr.nhs.uk

The first 150 words of the full text of this article appear below.

Introduction

Adult coeliac disease is usually associated with a presentationof weight loss, diarrhoea, and malabsorption of nutrients. Weare now seeing, however, increased numbers of silent, or subclinical,cases, which are often picked up by the finding of an unexplainedanaemia.¹ Despite this change, few clinicians would expect obesityto be part of the presentation. Here we describe four casesthat show that we should not be dissuaded from a potential diagnosisof coeliac disease on the basis of a patient's body weight.This is especially pertinent in today's society, where 22% ofmen and 23% of woman in the United Kingdom are now obese (bodymass index > 30).²

Case histories

A 53 year old woman was referred to the gastroenterology departmentwith an 18 month history of diarrhoea and a background of almostlifelong irregular bowel habit. She had always been overweight,and there had been no recent change. She . . . [Full text of this article]

Discussion

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