Neuromuscular disorder as a presenting feature of coeliac disease

Hadjivassiliou, Marios; Chattopadhyay, Arup; Davies‐Jones, G.A.B.; Gibson, A. A. M.; Grünewald, Richard A.; Lobo, Alan

doi:10.1136/jnnp.63.6.770

Cited by 94 publications

(70 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2 Among these extraintestinal manifestations, there is a growing body of publications that report neurologic conditions that are associated with CD. [3][4][5][6][7][8][9][10][11][12] Although earlier studies reported neurologic complications in patients with classical gluten enteropathy, some recent studies report neurologic disorders in asymptomatic CD patients. 13,14 Most of the patients who have CD and were reported as having neurologic manifestations were adults, and these manifestations were usually chronic and "hard," such as epilepsy, 12 cerebellar ataxia, 4,5,13,14 chronic neuropathies, 8,15 myoclonic ataxia, 9 progressive leukoencephalopathy, 7 and dementia.…”

mentioning

confidence: 99%

Range of Neurologic Disorders in Patients With Celiac Disease

et al. 2004

View full text Add to dashboard Cite

ABSTRACT. Objective. During the past 2 decades, celiac disease (CD) has been recognized as a multisystem autoimmune disorder. A growing body of distinct neurologic conditions such as cerebellar ataxia, epilepsy, myoclonic ataxia, chronic neuropathies, and dementia have been reported, mainly in middle-aged adults. There still are insufficient data on the association of CD with various neurologic disorders in children, adolescents, and young adults, including more common and "soft" neurologic conditions, such as headache, learning disorders, attention-deficit/hyperactivity disorder (ADHD), and tic disorders. The aim of the present study is to look for a broader spectrum of neurologic disorders in CD patients, most of them children or young adults.Methods. Patients with CD were asked to fill in a questionnaire regarding the presence of neurologic disorders or symptoms. Their medical charts were reviewed, and those who were reported as having neurologic manifestations underwent neurologic examination and brain imaging or electroencephalogram if required. Their neurologic data were compared with that of a control group matched for age and gender.Results. Patients with CD were more prone to develop neurologic disorders (51.4%) in comparison with control subjects (19.9%). These disorders include hypotonia, developmental delay, learning disorders and ADHD, headache, and cerebellar ataxia. Epileptic disorders were only marginally more common in CD. In contrast, no difference was found in the prevalence of tic disorders in both groups. Therapeutic benefit, with gluten-free diet, was demonstrated only in patients with transient infantile hypotonia and migraine headache.Conclusion. This study suggests that the variability of neurologic disorders that occur in CD is broader than previously reported and includes "softer" and more common neurologic disorders, such as chronic headache, developmental delay, hypotonia, and learning disorders or ADHD. Future longitudinal prospective studies might better define the full range of these neurologic disorders and their clinical response to a gluten-free diet. Pediatrics 2004;113:1672-1676; celiac disease, neurologic disorders, migraine, attention-deficit/hyperactivity disorder, hypotonia.ABBREVIATIONS. CD, celiac disease; ADHD, attention-deficit/ hyperactivity disorder.A lthough in the past celiac disease (CD) was primarily considered to be a gluten enteropathy, during the past 2 decades, its clinical concept has been expanded, and it is now considered a multisystem autoimmune disorder, 1 with most of the patients being asymptomatic, oligosymptomatic, or present with extraintestinal manifestations. 2 Among these extraintestinal manifestations, there is a growing body of publications that report neurologic conditions that are associated with CD. 3-12 Although earlier studies reported neurologic complications in patients with classical gluten enteropathy, some recent studies report neurologic disorders in asymptomatic CD patients. 13,14 Most of the patients who have CD and were reported ...

show abstract

mentioning

confidence: 99%

Range of Neurologic Disorders in Patients With Celiac Disease

et al. 2004

View full text Add to dashboard Cite

show abstract

“…CD can be associated with various neurological diseases such as polyneuropathy, cerebellar ataxia, epilepsy, myelopathy and multifocal leucoencephalopathy [4][5][6][7] . Peripheral neuropathy is one of the most frequent neurological disturbances in CD.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, associa-tion with CD, peripheral neuropathy and neuromuscular disorders has been documented [7] . The relationship between CD and different kinds of myopathies such as dermatomyositis, polymyositis and sporadic inclusion-body myositis, has also been reported [9][10][11] .…”

Section: Discussionmentioning

confidence: 99%

Celiac disease manifested by polyneuropathy and swollen ankles

Djurić

Kamenov²,

Katić³

2007

WJG

View full text Add to dashboard Cite

A 27-year-old male started to have his ankles swollen during his military service. He was examined at a military hospital where electromyoneurography showed the signs of distal sensory-motor polyneuropathy with axon demyelinization and weak myopathic changes, whereas histopathological examination of gastrocnemius muscle biopsy revealed some mild and nonspecific myopathy. Besides, he was found to have subcutaneous ankle tissue edemas and hypertransaminasemia. Due to these reasons, he was dismissed from the military service and examined at another hospital where bone osteodensitometry revealed low bone mineral density of the spine. However, his medical problems were not resolved and after the second discharge from hospital he was desperately seeing doctors from time to time. Finally, at our institution he was shown to have celiac disease (CD) by positive serology (antitissue transglutaminase and antiendomysial antibodies) and small bowel mucosal histopathological examination, which showed total small bowel villous atrophy. Three months after the initiation of gluten-free diet, his ankle edema disappeared, electromyoneurographic signs of polyneuropathy improved and liver aminotransferases normalized. Good knowledge of CD extraintestinal signs and serologic screening are essential for early CD recognition and therapy.

show abstract

“…The commonest types are symmetrical sensorimotor axonal length dependent peripheral neuropathy and sensory ganglionopathy (Hadjivassiliou et al, 2010b). Other types of neuropathies have also been reported including asymmetrical neuropathy (Kelkar et al, 1996;Hadjivassiliou et al, 1997;Chin et al, 2006) small fibre neuropathy (Brannagan et al, 2005) and rarely pure motor neuropathy (Hadjivassiliou et al, 1997) or autonomic neuropathy (Gibbons and Freeman, 2005). Gluten neuropathy is slowly progressive with a mean age at onset of the neuropathy being 55 years (range 24 to 77) and a mean duration of 9 years (range 1 to 33).…”

Section: Gluten Neuropathymentioning

confidence: 99%

The Neuroimmunology of Gluten Intolerance

Hadjivassiliou

Sanders

Aeschlimann

2016

Neuro-Immuno-Gastroenterology

View full text Add to dashboard Cite

The term Gluten Related Disorders (GRD) denotes a spectrum of diverse immune mediated diseases triggered by the ingestion of gluten (protein found in wheat, barley and rye). Coeliac disease (CD) or gluten sensitive enteropathy is the most recognised and studied entity within GRD.Extraintestinal manifestations, are gaining recognition and are increasingly the subject of further studies as they may hold the key to unravelling the pathophysiology of GRD. Such manifestations include skin involvement in the form of dermatitis herpetiformis (DH) and neurological dysfunction (eg gluten ataxia and gluten neuropathy). Furthermore the recent concept of extraintestinal manifestations without enteropathy (termed Non-Coeliac Gluten Sensitivity-NCGS) has become accepted as part of the same spectrum. In this chapter we review the neurological manifestations in GRD, discuss recent advances in diagnosis, and possible pathophysiological mechanisms.

show abstract

Neuromuscular disorder as a presenting feature of coeliac disease

Cited by 94 publications

References 16 publications

Range of Neurologic Disorders in Patients With Celiac Disease

Range of Neurologic Disorders in Patients With Celiac Disease

Celiac disease manifested by polyneuropathy and swollen ankles

The Neuroimmunology of Gluten Intolerance

Contact Info

Product

Resources

About