ABSTRACT
Untreated celiac disease can lead to serious behavioral disorders. We describe three adult patients with undiagnosed or untreated celiac disease without particular intestinal signs, causing persistent depressive symptoms in three of the parents of our pediatric patients. In two of the three cases, the pediatrician suspected the diagnosis when taking the family history of the children. In fact, a diagnosis of celiac disease was made during childhood, when they had intestinal symptoms, but the gluten-free diet was spontaneously interrupted during the teenage period because of the disappearance of the typical intestinal signs. In the third case the mother was tested for antiendomysium antibodies (EmA), as she had a diagnosed celiac child. In all three patients, the depressive symptoms improved quickly with a gluten-free diet. In conclusion, celiac disease should be taken into consideration in the presence of behavioral and depressive disorders, particularly if they are not responsive to the usual antidepressive therapy.
Subject(s)
Celiac Disease/diagnosis , Depressive Disorder/etiology , Adult , Celiac Disease/complications , Celiac Disease/diet therapy , Celiac Disease/genetics , Child, Preschool , Depressive Disorder/therapy , Female , Humans , Infant , Male , PediatricsABSTRACT
With the improved life expectation of patients with beta-thalassemia-major (BTM) or Cooley's Disease, new clinical problems, such as hearing damage, have emerged. The authors describe audiometric data of 50 patients with BTM. High-frequency thresholds were higher in BTM than those of a control group. Prevalence of hearing loss in BTM was 14-26%, depending on the frequency range considered, while in the control group it was between 4.3-19.1%. The prevalence of hearing loss in BTM with respect to that of the general population was 7-10% higher. Hearing loss ranged from mild to moderate. A good correlation was found between hearing loss and the cumulative dose of desferoxamine administered. These data were indicative of an ototoxic effect of this drug. Many patients (28.6%) showed significant hearing threshold deterioration after 3 years. On the light of these results, the authors suggest regular audiologic follow-up of patients with BTM.
