Introduction:We report a case of sero-negative celiac disease in Pakistan. Case Presentation: A 20-year-old female presented with papulovesicular rash for 15 years, diarrhea for 8 years, spasms of hands and twitching of face for 4-5 months. She had mild anemia, low vitamin-D3 and serum calcium. On exclusion of other causes of malabsorption, anti-tissue transglutaminase antibodies (immunoglobulin-A & immunoglobulin-G), anti-endomysial antibodies, total immunoglobulin-A levels and skin biopsy were performed, which were normal. Intestinal biopsy revealed subtotal villous atrophy. Patient was prescribed gluten-free diet, to which she responded with alleviation of symptoms.
Negative serology should not rule out celiac disease, intestinal biopsy should be performed if there is strong clinical suspicion.
(2009). Sero-negative celiac disease with dermatitis herpetiformes: a case report.. Cases Journal, 2, 7512.
Available at: http://ecommons.aku.edu/pakistan_fhs_mc_surg_surg/78