Gluten hyper sensitivity: an unseen storm of neurological spectrum disorders

Authors

  • Ansh Chaudhary Department of Medicine, Bharati Vidyapeeth Medical College and Research Centre, Pune, Maharashtra, India
  • Bhupendra Chaudhary Department of Neurology, Jaswant Rai Super Speciality Hospital, Meerut, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20202065

Keywords:

Ataxia, Coeliac disease, Gluten-free, Gluten sensitivity, Neuropathy

Abstract

Gluten sensitivity, an autoimmune systemic disease with its protean manifestation occur in genetically susceptible individuals with gluten in their diet. Coeliac disease is the intestinal form of disease mostly seen in children with predominant gastrointestinal manifestations. The neurological presentation of gluten sensitivity mostly without enteropathy are also frequent and affect adult population in contrast. The most common presentation includes cerebellar ataxia, peripheral neuropathy and seizure followed by encephalopathy, schizoaffective and movement related manifestations. These varied clinical presentations are attributed to an immune related attack on central and peripheral nervous system involving both adaptive and innate immunity. Early suspicion, prompt diagnosis and institution of gluten free diet provides remarkable benefits to these patients with amelioration of troublesome symptoms. A better understanding of disease etiopathogenesis is likely to add more therapeutic options.

References

Marsh MN. The natural history of gluten sensitivity: defining, refining and re-defining. QJM: Int J Medi. 1995 Jan 1;88(1):9-13.

Dicke WK, Weijers HA, KAMER JV. Coeliac Disease The Presence in Wheat of a Factor Having a Deleterious Effect in Cases of Coeliac Disease. Acta Paediat. 1953 Jan;42(1):34-42.

Grodzinsky E, Franzen L, Hed J, Ström M. High prevalence of celiac disease in healthy adults revealed by antigliadin antibodies. Ann Aller. 1992 Jul;69(1):66-70.

Cooke WT, Smith WT. Neurological disorders associated with adult celiac disease. Brain. 1966 Dec 1;89(4):683-722.

Hadjivassiliou M, Grünewald RA, Chattopadhyay AK, Davies-Jones GA, Gibson A, Jarratt JA, et al. Clinical, radiological, neurophysiological, and neuropathological characteristics of gluten ataxia. Lancet. 1998 Nov 14;352(9140):1582-5.

Hadjivassiliou M, Chattopadhyay AK, Davies-Jones GA, Gibson A, Grünewald RA, Lobo AJ. Neuromuscular disorder as a presenting feature of coeliac disease. J Neurol, Neurosurg Psych. 1997 Dec 1;63(6):770-5.

Bouquet F, Ventura A, Gobbi G, Greco L, Lambertini A, Zaniboni MG, Tassinari CA. Coeliac disease, epilepsy, and cerebral calcifications. Lancet. 1992 Aug 22;340(8817):439-43.

Julian T, Hadjivassiliou M. Zis P. Gluten sensitivity and epilepsy: a systematic review. J Neurol 2018:16(8):1014-38.

Catassi C, Rätsch IM, Fabiani E, Rossini M, Coppa GV, Giorgi PL, et al. Coeliac disease in the year 2000: exploring the iceberg. Lancet. 1994 Jan 22;343(8891):200-3.

Zis P, Rao DG, Sarrigiannis PG, Aeschlimann P, Aeschlimann DP, Sanders D, et al. Transglutaminase 6 antibodies in gluten neuropathy. Digest Liver Dis. 2017 Nov 1;49(11):1196-200.

Holmes GK. Neurological and psychiatric complications in coeliac disease. Epilepsy and other neurological disorders in coeliac disease. London: John Libbey. 1997;251:64.

Hadjivassiliou M, Davis Jones GAB, Sanders DS, Gvunewald RAG. Dietary treatment of gluten ataxia. J Neurol Neurosurg Psych. 2003;74(9):1221-4.

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Published

2020-05-22

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Section

Short Communication