Bilateral calcifications in the basal ganglia, and frontal and parietal lobes of a patient with coeliac disease

Pediatr Radiol (2005) 35: 710712DOI 10.1007/s00247-005-1416-8 CASE REPORT

Selman Vefa Yildirim Filiz Tiker Ozlem Barutcu Nurcan Cengiz

Bilateral calcications in the basal ganglia, and frontal and parietal lobes of a patient with coeliac disease

Received: 2 September 2004 Revised: 29 November 2004 Accepted: 6 December 2004 Published online: 16 February 2005 Springer-Verlag 2005

Abstract Previous authors have described a specic syndrome of coeliac disease, bilateral cerebral calcications and epileptic seizures. We report a 4-year-old boy with coeliac disease who had bilateral calcications in the basal ganglia and frontal and parietal lobes, but did not exhibit epileptic seizures.

Keywords Coeliac disease Brain Calcication Basal ganglia Child

S. V. Yildirim (&) F. Tiker N. Cengiz Department of Paediatrics, Baskent University Medical Faculty, Adana Hospital, Adana Hastanesi Cocuk Bolumu, 01140 Seyhan-Adana, Turkey E-mail: [email protected].: [phone]Fax: [phone]

O. BarutcuRadiology Department, Fatih University Medical Faculty, Ankara, Turkey

Introduction Coeliac disease (CD) is a disorder in which the mucosa of the proximal small bowel is damaged as a result of dietary exposure to gluten [1]. The condition is one of permanent intolerance to gluten, and the most common time of presentation is between 6 months and 2 years of age. The presentation varies; diarrhoea, failure to thrive, anorexia and abdominal distension are the commonest symptoms [1]. A specic syndrome of CD with epileptic seizures and cerebral calcications was rst described in 1988 [2]. Several series and case reports have subsequently been published, mainly by Italian authors [37]. Here, we describe a patient with CD who had cerebral calcication with atypical localization, and who did not exhibit epileptic seizures.

Case report A 4-year-old boy presented to our department because of recurrent headache. He had been diagnosed with CD at the age of 3 years, based on the presence of anti-gliadin antibodies and marked villous atrophy on a jejunal biopsy. At the time of presentation, he was on a gluten-free diet. There was no history of seizure activity, ataxia or syncope. Neurological examination was normal.

Head CT (Fig. 1)...