eng Science and Education Publishing International Journal of Celiac Disease 2334-3486 2019-08-13 7 2 53 55 10.12691/ijcd-7-2-5 IJCD2019725 article Hugh J. Freeman hugfree@shaw.ca 1 Department of Medicine (Gastoenterology), University of British Columbia, Vancouver, British Columbia, Canada A woman with long-standing weight loss and malabsorption demonstrated a severe sprue-like enteropathy. She insidiously developed persistent and progressive muscle weakness caused by inclusion body myositis, an uncommon muscle disorder. Treatment with a gluten-free diet, steroids, calcium, zinc and vitamin supplements, including empirical vitamin E resulted in weight gain, but failed to histologically improve her small intestinal mucosa or the muscle weakness which became profound. The myopathic process could reflect a co-existent autoimmune disorder, or, possibly a direct result of long-standing and superimposed nutrient deficits. An alternative explanation may be a hitherto unrecognized syndrome manifested as inclusion body myositis and a form of sprue-like enteropathy. http://pubs.sciepub.com/ijcd/7/2/5/ijcd-7-2-5.pdf celiac disease gluten enteropathy small bowel ulcer non-granulomatous ulcerative jejunitis myopathy inclusion body myositis