Bosphorus Med J. 2019; 6(3): 99-102 | DOI: 10.14744/bmj.2019.73645

Silent Celiac Disease and Primary Biliary Cirrhosis Underlying Fibromyalgia: A Case Report

Aliye Tosun¹, Sinan Akay², Ümit Seçil Demirdal¹, Zehra Akpýnar², Korhan Barýþ Bayram³, Semra Ergan³, Ayhan Aþkýn^1
1Department of Physical Medicine and Rehabilitation, Izmir Katip Celebi University Faculty of Medicine, Izmir, Turkey
²Department of Gastroenterology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
³Department of Physical Medicine and Rehabilitation, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey

Fibromyalgia syndrome (FMS) is characterized by chronic widespread musculoskeletal pain, stiffness and tenderness at multiple points. FMS can be classified as primary or secondary according to the presence of other medical disorders. Irritable bowel syndrome, a comorbid disorder frequently associated with FMS, has also been reported to be associated with celiac disease (CD) in which gluten triggers an autoimmune reaction in the small intestinal mucosa, which results in inflammation, villous atrophy, and malabsorption. Primary biliary cirrhosis (PBC) is the most common reported liver disease in CD. A gluten-free diet is the only effective treatment for CD and prevents the troublesome consequences of the disease. Herein, we present a fibromyalgic female patient in whom the diagnosis of CD and PBS were established upon investigating the causes of elevated liver biochemistry tests and iron-deficiency anemia.

Keywords: Celiac disease, fibromyalgia, primary biliary cirrhosis

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Fibromiyalji Altýnda Yatan Sessiz Çölyak Hastalýðý ve Primer Biliyer Siroz: Bir Olgu Sunumu

Aliye Tosun¹, Sinan Akay², Ümit Seçil Demirdal¹, Zehra Akpýnar², Korhan Barýþ Bayram³, Semra Ergan³, Ayhan Aþkýn^1
1Fiziksel Týp ve Rehabilitasyon Anabilim Dalý, Ýzmir Katip Çelebi Üniversitesi, Týp Fakültesi, Ýzmir, Türkiye
²Gastroenteroloji Kliniði, Ýzmir Katip Çelebi Üniversitesi Atatürk Eðitim ve Araþtýrma Hastanesi, Ýzmir, Türkiye
³Fiziksel Týp ve Rehabilitasyon Kliniði, Ýzmir Katip Çelebi Üniversitesi Atatürk Eðitim ve Araþtýrma Hastanesi, Ýzmir, Türkiye

Fibromiyalji sendromu (FMS), kronik yaygýn kas iskelet sistemi aðrýsý, sertlik ve çoklu noktalardaki hassasiyet ile karakterizedir. FMS, diðer týbbi bozukluklarýn varlýðýna göre primer veya sekonder olarak sýnýflandýrýlabilir. Sýklýkla FMS ile iliþkili komorbid bir hastalýk olan irritabl baðýrsak sendromunun, gluten'in inflamasyon, villöz atrofi ve malabsorpsiyon ile sonuçlanan ince baðýrsak mukozasýnda bir otoimmün reaksiyonu tetiklediði çölyak hastalýðý (ÇH) ile iliþkili olduðu bildirilmiþtir. Primer biliyer siroz (PBS), ÇH’de en sýk bildirilen karaciðer hastalýðýdýr. Glutensiz bir diyet, ÇH için tek etkili tedavidir ve hastalýðýn zahmetli sonuçlarýný önler. Burada yüksek karaciðer biyokimya testleri ve demir eksikliði anemisinin nedenlerini araþtýrdýktan sonra ÇH ve PBS tanýsý alan bir fibromiyaljik kadýn hastayý sunuyoruz.

Anahtar Kelimeler: Çölyak hastalýðý, fibromiyalji, primer biliyer siroz

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