Depression in adult untreated celiac subjects: Diagnosis by the pediatrician

Untreated celiac disease can lead to serious behavioral disorders. We descr ibe three adult patients with undiagnosed or untreated celiac disease witho ut particular intestinal signs, causing persistent depressive symptoms in t hree of the parents of our pediatric patients. In two of the three cases, t he pediatrician suspected the diagnosis when taking the family history of t he children. In fact, a diagnosis of celiac disease was made during childho od, when they had intestinal symptoms, but the gluten-free diet was spontan eously interrupted during the teenage period because of the disappearance o f the typical intestinal signs. In the third case the mother was tested for antiendomysium antibodies (EmA), as she had a diagnosed celiac child. In a ll three patients, the depressive symptoms improved quickly with a gluten-f ree diet. In conclusion, celiac disease should be taken into consideration in the presence of behavioral and depressive disorders, particularly if the y are not responsive to the usual antidepressive therapy. (Am J Gastroenter ol 1999;94:839-843. (C) 1999 by Am. Coll. of Gastroenterology).