Severe chilblains were the only symptom of coeliac disease for a 12-year-old girl, whose mother made the suggestion to test for the autoimmune disorder, a case report shows. 

The girl had experienced chilblains for five years before being referred to the dermatology department at a Montreal hospital, the Canadian doctors said. 

Painful lesions at the tip of her fingers, toes (pictured) and ears had been intensifying, occurring annually from October to mid-April when the weather was cold.

At her initial examination at the CHU Sainte Justine Hospital, she reported no weight loss, or gastrointestinal symptoms, nor did she show any connective tissue disease signs, other than the chilblains.