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Unusual association of diseases/symptoms
Multiple sclerosis-like neurological manifestations in a coeliac patient: nothing is as it seems
  1. Pasquale Mansueto1,
  2. Laura Di Stefano1,
  3. Alberto D'Alcamo1,
  4. 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.

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  • Competing interests None.

  • Patient consent Obtained.

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