Coeliac disease presenting with chorea

[Scott Adams]

It is a single case study, but I thought it was interesting. https://pn.bmj.com/content/20/2/144.full

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Abstract

Chorea can be genetic or acquired, and often leads to a challenging diagnostic conundrum. In a significant proportion, there is no specific identifiable cause. Chorea is a rare but potentially reversible neurological manifestation of coeliac disease, usually presenting insidiously and often presumed to be associated with typical gastrointestinal symptoms. We report a patient with rapidly progressive generalised chorea, but without preceding gastrointestinal symptoms, who was subsequently diagnosed with coeliac disease. A gluten-free diet resulted in complete resolution of the chorea.

 

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After 7 weeks on the gluten-free diet, her chorea had completely resolved (video 2) and the titre of anti-tissue transglutaminase (tTG) IgA titre had markedly reduced (6.8 U/mL). She remained chorea-free when reviewed 6 months later.