CELIAC-DISEASE ASSOCIATED WITH PERIPHERAL NEUROPATHY IN A CHILD - A CASE-REPORT

Clinical features and pathological findings of sural nerve biopsy are reported of a 3-year-old child affected with coeliac disease who devel oped a progressive polyneuropathy, unresponsive to a gluten-free diet, nor to vitamin E and folic acid supply. There was no evidence of mala bsorption, nor of blood factor deficiency, nor of metabolic abnormalit ies which might account for the neuropathy. A sural nerve biopsy showe d marked loss of myelinated fibres without evidence of regenerative ph enomena. Distal involvement and features of nerve pathology are consis tent with a ''dying-back'' mechanism to underlie the nerve damage. The lack of response to a gluten-free diet suggests that direct toxicity of gliadin is not implicated.