Follow-up of muscular sarcoidosis using fluorodeoxyglucose positron emission tomography.

onset of the seizures are quite variable in CD as the duration of gluten exposure is important 1 and a correlation can be found between the duration of the disease preceding the diagnosis (and treatment) and neurological findings as detected even years after the diagnosis. 11,12 The two conditions may coexist for a prolong period of time before the actual clinical manifestations which may be till the late middle age as in our patient. Our case demonstrate that neurological symptom such as epilepsy may be the first manifestation of CD and the diagnosis may be often challenging as the frequency of undiagnosed CD in neurological manifestations of unknown origin may be as high as 16%. 6 A high index of suspicion for CD should be borne in mind in patients with epilepsy with non-specific GI or constitutional symptoms. 13 Although routine screening for CD in all patients with epilepsy is not cost-effective, it is reasonable to perform it in patients with neurological dysfunctions of unknown cause 14 and in patients with intractable epilepsy. 8 Early institution of a gluten-free diet in combination with antiepileptic treatment is beneficial as delay in diagnosis of CD in epilepsy patients or poor dietary compliance may adversely influence the overall outcome and lead to complications. et al. Bilateral occipital calcification, epilepsy and coeliac disease: clinical and neuroimaging features of a new syndrome. et al. Anti brain but not coeliac disease antibodies in Landau-Kleffner syndrome and related epilepsies. A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet 1996; 347:369–71. 7. Labate A, Gambardella A, Messina D. Silent coeliac disease in patients with childhood localization related epilepsies. Spriroglou K. Successful treatment of epilepsy and coeliac disease with a gluten free diet. Neurological complications of coe-liac disease: a rare but continuing problem. et al. Coeliac disease related antibodies in an epilepsy cohort and matched reference population. Follow-up of muscular sarcoidosis using fluorodeoxyglucose positron emission tomography Sir, Sarcoidosis is an immune-mediated condition affecting numerous organs, especially the lungs, lymph nodes, skin and eyes. 1 Although asymptomatic muscle involvement is common in sarcoidosis (50–80% of histological cases), symptomatic myo-pathy is rare, being encountered in 0.5–2.3% of the patients. 1 We recently observed a case of symptomatic myositis revealing a recurrence of sarcoidosis with favorable outcome after initiation of infliximab; our case is of particular interest, as it indicates that whole body fluorodeoxyglucose posi-tron emission tomography (FDG-PET) is …