Celiac disease in older persons: A case of seronegative disease

A 68-year-old man with a history of smoking (former smoker of 40 cigarettes per day), euthyroid goiter, deep vein thrombosis and depression, came to our attention for weakness, cachexia, abdominal bloating and diarrhea lasting for almost six months. Furthermore, he had lost about 25 kilograms of weight in the last year and was bedridden for three months. Combining the results of serological, histopathological and genetic tests, he was diagnosed with a seronegative celiac disease. Gluten-free diet, combined with nutritional supplements and physical therapy, improved his clinical condition and allowed the recovery of weight and the walking ability. Celiac disease might be suspected in elderly patients with diarrhea, malabsorption, malnutrition and cachexia, but also with other symptoms such as anemia, micronutrients' deiciency, fragility fractures and neurological symptoms.