[The impairement of bone formation and resorption in 25-year-old man with neglected celiac disease].

Bone turnover impairement and low bone density in 25-year-old man with active celiac disease was presented. The patient refused gluten-free diet compliance and clinically showed doughy abdomen, hyperpigmentation, finger clubbing and koilonychia. In serum, we obtained about 2-fold of formation markers (osteocalcin, bone alkaline phosphatase) and and 5-fold higher levels of resorption marker (collagen type I crosslinked C-telopeptide). The concentration of osteoprotegerin was slightly above normal range. We observed the trace amounts of 25-(OH)D in serum whereas the level of parathormone was 2-fold higher than in controls. Serum calcium and phosphorus were often below normal range. In dual X-ray absorptiometry (DXA) whole-body bone density was remarkably reduced. Our results suggest, that on gluten-containing diet the patient will develop lower bone mineral density and higher risk of fractures and skeletal deformities.