Acrodystrophic axonal polyneuropathy with celiac disease: a case report.

BACKGROUND: Patients with celiac disease present with not only gastrointestinal symptoms but also extraintestinal manifestations such as anemia, osteopathy, dermatitis herpetiformis, and celiac neuropathy. Despite a fairly wide range of celiac neuropathies, we report a case of the acrodystrophic variant of celiac polyneuropathy, which has not been previously described. CASE PRESENTATION: A 41-year-old Ukrainian male suffered from symmetric, sensorimotor axonal polyneuropathy and encephalopathy associated with celiac disease, which is characterized by severe trophic disorders in the lower extremities (trophic ulcers, hyperkeratosis, and anhidrosis). Acrodystrophic changes in the lower extremities were due to both neurogenic and direct immunoinflammatory damaging effects. Clinical-electrophysiological dissociation was also noted, which was represented by a gross axonal lesion with the preservation of muscle strength. The absence of enteropathic manifestations was accompanied by the pronounced histological changes in the duodenal mucosa by IIIb stage of Marsh. A gluten-free diet in combination with membrane plasma exchange and intravenous pulse methylprednisolone was prescribed to reduce the severity of sensory disorders and regression of encephalopathy within 7 months. CONCLUSION: Celiac disease may be a potential cause of neuropathy and encephalopathy in adult patients. Further immunosuppressive treatment protocols for both intestinal and extraintestinal manifestations of celiac disease are required.

[Comparative study of the energy-stabilizing and immunotropic properties of trekrezan and polyoxidon on a bronchopulmonary inflammation model in rats].

The energy-stabilizing and immunotropic action of immunomodulants trekrezan (25 mg/kg) and polyoxidon (0.75 mg/kg) was compared in rats with a model bronchopulmonary inflammation induced by the introduction of turpentine into trachea. Both drugs exhibited an energy-stabilizing effect, which was manifested by a decrease in the levels of lactate and the ATP-ADP and AMP hydrolysis products and by an increase in the level of pyruvate and ATP in blood lymphocytes and lung tissues. The energy-stabilizing action of polyoxidon was more pronounced in the lung tissue. The action of this drug was generally the same, but less pronounced than the effect of trekrezan. The parallel experiments showed that trekrezan and polyoxidon normalized the immune status of lymphocytes in rats with the model acute bronchopulmonary inflammation.

Efficiency of trekrezan in experimental bronchopneumonia in rats.

Trekrezan in a dose of 25 mg/kg normalized the lymphocyte immune status and produced an energy-stabilizing effect, which manifested in decreased levels of lactate, ADP, and AMP and increased content of pyruvate and ATP in blood lymphocytes and lung tissue of rats with experimental acute bronchopneumonia.