We report on a 48-year-old woman with coeliac disease who developed os
teonecrosis of the femoral head after being treated with steroids for
nonresponse to gluten withdrawal. We stress the possible role of osteo
porosis and osteomalacia, frequently found in patients with coeliac di
sease, in the pathogenesis of this complication, and advise using drug
s other than steroids in the treatment of refractory coeliac disease.