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Celiac neuropathy.

R L Chin1, H W Sander, T H Brannagan

  • 1Peripheral Neuropathy Center, Department of Neurology and Neuroscience, Weill Medical College of Cornell University, New York, NY 10022, USA. RUC9002@med.cornell.edu

Neurology
|May 29, 2003
PubMed
Summary
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Celiac disease (CD) is frequently linked to sensory neuropathy, even without typical digestive symptoms. This study highlights the importance of considering CD in neuropathy patients.

Area of Science:

  • Neurology
  • Gastroenterology
  • Immunology

Background:

  • Celiac disease (CD) is an autoimmune enteropathy triggered by gluten ingestion.
  • Neurologic complications affect up to 10% of CD patients, primarily ataxia and peripheral neuropathy.
  • The incidence and presentation of CD-associated peripheral neuropathy remain understudied.

Purpose of the Study:

  • To establish the incidence of celiac disease in patients presenting with neuropathy.
  • To delineate the clinical characteristics of celiac disease-associated neuropathy.

Main Methods:

  • Retrospective review of medical records for 20 patients with biopsy-confirmed celiac disease and neuropathy.
  • Analysis of clinical symptoms, electrophysiologic studies, and sural nerve biopsy findings.

Related Experiment Videos

  • Serologic testing for ganglioside antibodies using an agglutination assay.
  • Main Results:

    • Nine patients (45%) presented with neuropathy as the initial or sole manifestation of CD.
    • Sensory symptoms (burning, tingling, numbness, distal loss) were predominant; weakness was rare.
    • Electrophysiologic studies were often normal (90%), while nerve biopsies showed axonopathy; 65% tested positive for ganglioside antibodies.

    Conclusions:

    • Celiac disease is a common cause of sensory neuropathy, particularly when electrophysiologic studies are normal.
    • CD should be suspected in patients with neuropathy, irrespective of gastrointestinal symptoms.
    • Ganglioside antibodies may serve as a potential biomarker for CD-associated neuropathy.