BMJ Case Reports 2012; doi:10.1136/bcr-2012-006392
  • Unusual association of diseases/symptoms

Multiple sclerosis-like neurological manifestations in a coeliac patient: nothing is as it seems

  1. Antonio Carroccio2
  1. 1Internal Medicine, Department of Internal and Specialistic Medicine, University Hospital of Palermo, Palermo, Italy
  2. 2Department of Internal Medicine, Hospital of Sciacca, Agrigento, Italy
  1. Correspondence to Professor Pasquale Mansueto, pasquale.mansueto{at}

Cobalamin (vitamin B12) deficiency occurs with several disorders, involving different organs and systems, including blood, bowel, nervous system and eyes. Although the most important features are usually haematological ones, presence of neurological involvement, in the absence of blood count alterations, has just been described in the literature. Here we report the case of a 48-year-old man, suffering from coeliac disease for approximately 5 years, vegetarian, who was admitted to our department, referring dysaesthesia of the left lower limb, decreased libido and erectile dysfunction. Vitamin B12 deficiency was proved, even in the absence of blood count alteration, and treated with a vitamin supplement, resulting in complete remission.


  • Competing interests None.

  • Patient consent Obtained.

Responses to this article

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article