Adult celiac disease with acetylcholine receptor antibody positive myasthenia gravis

Recent advances in celiac disease

“…Mental disorders, non-c omplianc e with the GFD, ac tive medic al c o-morbidities, and dissatisfac tion with doc tor/patient c ommunic ation were assoc iated with reduc ed CD Questionnaire sc ores [77] . Up to 10% of patients with CD have neurologic al symptoms ranging from polyneuropathy, epilepsy, myoclonus, multifocal leukoencephalopathy, dementia, chorea, migraine, memory/attention impairment and peripheral axonal and demyelinating neuropathies as well as ac etylc holine-antibody positive myasthenia gravis [78] . Autoimmunity may ac t as a mec hanism triggering neurologic al dysfunc tion [79] , and anti-neuronal, anti-gliadin and tTG antibodies may c ontribute to neurologic al impairment through Apaf-1 ac tivation with Bax and c ytoc hrome C transloc ation, leading to impairment of mitoc hondrialdependent apoptosis.…”

Rare association of celiac disease with myasthenia gravis in a patient with other immune disorders: A case report

“…The association between CD and myasthenia gravis could be coincidental, but available evidence suggests that these two distinct immune-mediated disorders occur together more frequently than is currently appreciated. Similar human leukocyte antigen types (HLA-DR3, -DQ2,-DQ8) seem to predispose to both MG and CD (3,11). Some serological surveys have investigated the concurrence of antibodies present in the two diseases, with no expressive results (2,3).…”

“…Similar human leukocyte antigen types (HLA-DR3, -DQ2,-DQ8) seem to predispose to both MG and CD (3,11). Some serological surveys have investigated the concurrence of antibodies present in the two diseases, with no expressive results (2,3). We found three studies in the literature reporting the association of these two diseases in which the diagnosis of CD preceded symptoms of MG (3,12,13), and one case in which subclinical CD was diagnosed after serological screening of tTG and EMA in patients with myasthenia gravis, confirmed by duodenal biopsy (3) (Table II).…”

“…There are reports of the occurrence of MG even after the introduction of a GFD in patients with CD (3,12). The role of a GFD in the course of autoimmune diseases has been studied, but there is no consensus in the literature regarding the course of neurological disorders associated with CD.…”

“…Myasthenia gravis (MG) is an autoimmune neuromuscular disorder that is rarely described in patients with CD (3). We report the case of a patient with CD who presented manifestations related to a hyperactive immune system, including macroamylasemia, false-positive anti-HCV, positive antinuclear antibody, Raynaud's phenomenon, and MG.…”