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

Abstract

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