Neuromuscular and sensory disturbances in patients with well treated celiac disease

University of Kuopio, Kuopio, Northern Savo, Finland
Journal of Neurology Neurosurgery & Psychiatry (Impact Factor: 5.58). 05/2003; 74(4):490-4. DOI: 10.1136/jnnp.74.4.490
Source: PubMed

ABSTRACT A body of evidence shows that coeliac disease is associated with protean manifestations outside the intestine, and neurological disorders are well recognised. However, it remains obscure whether there are signs of clinical or subclinical nervous system involvement even in patients adopting an adequate gluten free diet. The aim of this study was to assess in a controlled study whether patients with treated coeliac disease carry an increased risk for neuropathy and characterise the type of possible neuropathy.
Electroneuromyographic findings and vibration, thermal, and tactile thresholds of 26 patients with coeliac disease and 23 patients with reflux disease were analysed.
Six (23.1 %) coeliac disease patients and one (4.3 %) reflux disease patient showed findings of chronic axonal neuropathy in quantitative needle EMG. In addition, two coeliac disease patients showed findings suggestive for myopathy. There were no significant differences in warm, cold, or vibration thresholds between the groups but means of heat pain thresholds and tactile thresholds were significantly higher in coeliac patients than in controls.
An increased occurrence of axonal neuropathy was observed in well treated coeliac disease. This further indicates that neurological manifestations occur even in patients without overt malabsorption.

  • Source
    • "Obviously, patients with celiac disease should be encouraged to adhere to a gluten free diet; however, there are inconsistent reports regarding the effectiveness of this treatment for improvement of neurologic symptoms.(Grossman, 2008; Hadjivassiliou et al., 2003a; Hadjivassiliou et al., 2006b; Luostarinen et al., 2003; Tursi et al., 2006) 39–43 Based on our results, especially for the patients without underlying enteropathy, gluten free diet does not have a significant beneficial effect on the neurologic symptoms. In addition we did not observe any correlation between the course of neurologic disorders and serologic outcomes in our patients that may also suggest these are distinct entities. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The role and relevance of deamidated gliadin antibodies specific for celiac disease in gluten-sensitive ataxia/neuropathy is unknown. We investigated the association of celiac-specific serology with gluten-sensitive ataxia/neuropathy, in patients with and without gliadin-induced enteropathy. 51 patients with unexplained ataxia/neuropathy suspected to have gluten sensitivity were included in the study and their serum celiac-specific markers were measured. Deamidated gliadin-IgA (83% vs. 22%), deamidated gliadin-IgG (50% vs. 3%), tissue transglutaminase-IgA (78% vs. 11%), and anti-endomysial-IgA (70% vs. 0%), were significantly more positive in ataxia/neuropathy patients with celiac disease versus those without enteropathy (P<0.001). Our findings suggest that the serological profile of gluten-sensitive ataxia/neuropathy without intestinal involvement lacks the recognition of deamidated gliadin and tissue transglutaminase epitopes.
    Journal of neuroimmunology 11/2010; 230(1-2):130-4. DOI:10.1016/j.jneuroim.2010.09.024 · 2.79 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, 2008. Introdução: O ácido fólico é um dos elementos essenciais para o desenvolvimento normal do feto e sua deficiência durante a gestação pode resultar no aparecimento de defeitos do fecha-mento do tubo neural (DTN). A doença celíaca (DC), caracterizada por intolerância ao glúten, pode resultar em má absorção de nutrientes que frequentemente resulta em deficiência de ácido fólico e, conseqüentemente, numa possível maior prevalência de DTN na prole de mães com DC. Objetivo: Determinar a prevalência de DC em um grupo de mães de crianças porta-doras de DTN. Métodos: Mães com filhos afetados por DTN atendidas em ambulatório de Neu-rocirurgia Pediátrica do Hospital de Base de Brasília, foram submetidas ao teste de antiendo-mísio (IgA-EMA), pelo método de imunofluorescência indireta sobre secções criostáticas de esôfago de primata. Resultados: Foram investigadas 208 mães, com idades compreendidas entre 19 e 43 anos (média: 33 anos; mediana: 32 anos). Todas as mães apresentaram EMA negativo. Conclusões: Nossos resultados sugerem que a DC materna não é um fator de risco para aparecimento de DTN. Consequentemente, até o presente, uma rotina de rastreamento para DC em mulheres grávidas a fim de evitar uma possível gestação agravada por DTN não seria justificável. _______________________________________________________________________________________ ABSTRACT Introduction: Folic acid is one of the elements essential for the normal development of the fetus. Its deficiency during pregnancy can result in the appearance of neural tube closure defects (NTD). Celiac disease, characterized by intolerance to gluten, can result in poor absorption of nutrients potentially leading to deficiency of folic acid which could possibly result in a higher prevalence of NTD in celiac mothers offspring. Objective: To determine the prevalence of CD in a group of mothers of children affected by NTD. Methods: Mothers with children affected by NTD attending the walking in clinic of the Neuropediatric Surgical Unit of the Brasilia General Hospital, underwent antiendomysium serologic testing (IgA-EMA), utilizing the indirect immunofluorescence method on cryostat sections of monkey esophagus. Results: Two hundred-eight mothers, aged between 19 and 43 years (average: 33 years; median: 32 years) were tested. All mothers showed negative results on the EMA test. Conclusions: The negative results of the study suggest that celiac disease is not a risk factor for NTD in the offspring. Consequently, at this moment, routine screening for CD in pregnant women in order to avoid a possible pregnancy aggravated by NTD would not be justifiable.
  • 01/1995; 24. DOI:10.1016/S0167-9449(06)80128-X
Show more