Posterior Cerebral Calcifications in Celiac Disease: Improvement With Gluten-Free Diet

A 61-year-old man presented with a 15-year history of progressive bilateral vision loss. He reported neither gastrointestinal symptoms nor epilepsy. Brain CT and MRI showed bilateral occipital and cerebellar calcifications, and diffuse posterior white matter abnormalities (Figure 1). EEG demonstrated no epileptiform abnormalities. Duodenal biopsy results confirmed celiac disease (CD) diagnosis. White matter abnormalities decreased substantially after 8 months of gluten-free diet, and vision loss progression stopped (Figure 2). CD must be suspected in case of isolated neurovisual disturbances with posterior cerebral calcifications, considering that gluten-free diet can halt the deterioration.1,2 Late onset is not rare considering that in adults, CD is characterized by nonbowel involvement and extraintestinal symptoms.

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