Peripheral Neuropathic Symptoms in Celiac Disease and Inflammatory Bowel Disease

Shen, Ting-Chin David; Lebwohl, Benjamin; Verma, Himanshu; Kumta, Nikhil A.; Tennyson, Christina A.; Lewis, Suzanne K.; Scherl, Ellen; Swaminath, Arun; Capiak, Kristina M.; DiGiacomo, Daniel; Bosworth, Brian; Brannagan, Thomas; Green, Peter H.R.

doi:10.1097/cnd.0b013e31821c55a1

Cited by 33 publications

(20 citation statements)

References 34 publications

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“…15, 16 Peripheral neuropathy may precede the diagnosis of celiac disease and was reported by 39% of patients, based on responses to a validated questionnaire. 17 Seizures (sometimes associated with bilateral occipital calcifications), headaches, learning disorders, developmental delays, hypotonia, and attention deficit hyperactivity disorder are also observed more frequently in children with celiac disease, compared to controls. 18 Up to one third of adult patients were found to have a history of psychiatric disorders such as depression or personality changes, and less commonly, psychosis.…”

Section: Clinical Featuresmentioning

confidence: 99%

Advances in Diagnosis and Management of Celiac Disease

et al. 2015

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Celiac disease is an autoimmune disorder induced by dietary gluten in genetically predisposed individuals. It has a prevalence of ∼1% in many populations worldwide. New diagnoses have increased substantially, due to increased awareness, better diagnostic tools, and probable, real increases in incidence. The breadth of recognized clinical presentations continues to expand, making the disorder highly relevant to all physicians. Newer diagnostic tools, including serologic tests for antibodies against tissue transglutaminase (tTG) and deamidated gliadin peptide, greatly facilitate diagnosis. Tests for celiac-permissive HLA DQ2 and DQ8 molecules are useful in defined clinical situations. Celiac disease is diagnosed by histopathologic examination of duodenal biopsies. However, according to recent controversial guidelines, a diagnosis can be made without biopsy in certain circumstances, especially for children. Symptoms, mortality, and risk for malignancy can each be reduced by adherence to a gluten-free diet. This treatment is a challenge, however, as the diet is expensive, socially isolating, and not always effective in controlling symptoms or intestinal damage. Hence, there is increasing interest in developing non-dietary therapies.

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Section: Clinical Featuresmentioning

confidence: 99%

Advances in Diagnosis and Management of Celiac Disease

et al. 2015

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“…Moreover, some studies describe peripheral nerve involvement as the most frequent neurologic complication [31]. If causes of neuropathy are excluded, however, the reported frequency of PN in IBD will vary greatly among published studies, with estimates ranging from 0% to 39% due to selection bias, use of different definitions of the disease and diverse population characteristics [24,31,32,34,[38][39][40].…”

Section: Frequency Of Ibd-associated Peripheral Neuropathiesmentioning

confidence: 94%

“…At least 20% of these IBD patients had alternative potential etiologies for PN: 7% had diabetes, 10% vitamin B12 deficiency, 2% toxic medication use and 1% excessive alcohol consumption. As based on questionnaire, there is no definitive diagnosis of PN and no type of PN was obtained [34].…”

Section: Frequency Of Ibd-associated Peripheral Neuropathiesmentioning

confidence: 99%

Peripheral neuropathy: An underreported neurologic manifestation of inflammatory bowel disease

García-Cabo

Morís

2015

European Journal of Internal Medicine

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“…It is still possible that an unrecognized bias, such as outstanding management of nutritional deficiencies and immune status (referral bias) or genetic background could explain those discrepancies. The latter is unlikely since in a prospective study to evaluate neuropathic symptoms in IBD patients, very high percentages of neuropathic symptoms were found even inside the United States 18 .…”

Section: Discussionmentioning

confidence: 99%

A Case-Control study of the prevalence of neurological diseases in inflammatory bowel disease (IBD)

Gondim

Oliveira

Teles

et al. 2015

Arq. Neuro-Psiquiatr.

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Neurological diseases are common in inflammatory bowel disease (IBD) patients, but their exact prevalence is unknown. Method: We prospectively evaluated the presence of neurological disorders in 121 patients with IBD [51 with Crohn's disease (CD) and 70 with ulcerative colitis (UC)] and 50 controls (gastritis and dyspepsia) over 3 years. Results: Our standard neurological evaluation (that included electrodiagnostic testing) revealed that CD patients were 7.4 times more likely to develop large-fiber neuropathy than controls (p = 0.045), 7.1 times more likely to develop any type of neuromuscular condition (p = 0.001) and 5.1 times more likely to develop autonomic complaints (p = 0.027). UC patients were 5 times more likely to develop large-fiber neuropathy (p = 0.027) and 3.1 times more likely to develop any type of neuromuscular condition (p = 0.015). Conclusion: In summary, this is the first study to prospectively establish that both CD and UC patients are more prone to neuromuscular diseases than patients with gastritis and dyspepsia.Keywords: Chron's disease, inflammatory bowel disease, peripheral neuropathy, small fiber neuropathy, ulcerative colitis. RESUMO Doenças neurológicas são comuns em pacientes com doença inflamatória intestinal (DII), mas sua prevalência exata é desconhecida. Métodos: Nós estudamos prospectivamente a presença de distúrbios neurológicos em 121 pacientes com DII [51 com doença de Crohn (DC) e 70 com colite ulcerativa (RCU)] e 50 controles (gastrite e dispepsia) ao longo de 3 anos. Resultados: A avaliação neurológica padronizada (que incluiu testes eletrodiagnósticos) demonstrou que pacientes com DC foram 7,4 vezes mais propensos a desenvolver neuropatias de fibras grossas do que os controles (p = 0,045), 7,1 vezes mais propensos a desenvolver qualquer tipo de condição neuromuscular (p = 0,001) e 5,1 vezes mais propensos a desenvolver queixas autonômicas (p = 0,027). Pacientes com RCU foram 5 vezes mais propensos de desenvolver neuropatia de fibras grossas (p = 0,027) e 3,1 vezes mais propensos a desenvolver qualquer tipo de condição neuromuscular (p = 0,015). Conclusão: Em resumo, este é o primeiro estudo prospectivo a estabelecer que os pacientes tanto com DC quanto de RCU são mais propensos a doenças neuromusculares do que os pacientes com gastrite e dispepsia.Palavras-chave: doença de Crohn, doença inflamatória intestinal, neuropatia periférica, neuropatia de fibras grossas, colite ulcerativa.

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Peripheral Neuropathic Symptoms in Celiac Disease and Inflammatory Bowel Disease

Abstract: PN is more often found in patients with CD and/or IBD than in the general population.

Cited by 33 publications

References 34 publications

Advances in Diagnosis and Management of Celiac Disease

Advances in Diagnosis and Management of Celiac Disease

Peripheral neuropathy: An underreported neurologic manifestation of inflammatory bowel disease

A Case-Control study of the prevalence of neurological diseases in inflammatory bowel disease (IBD)

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