A 70-year-old man with isolated weight loss and a pellagra-life syndrome due to Celiac disease

An elderly man was diagnosed with celiac disease, which presented with thre e notable features: first, presentation at the age of 70 with no prior gast rointestinal symptomatology or positive family history; second, triggering of all symptoms following recent myocardial infarction and infective endoca rditis; third, presentation with marked (more than 20 percent) weight loss and pellagra-like skin lesions despite nearly normal examination and labora tory tests. Thus, celiac disease may present as a pellagra-like syndrome in the elderly with predominant weight less that is enhanced by the related t aste disturbances.