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Neuropathy associated with gluten sensitivity.

M Hadjivassiliou1, R A Grünewald, R H Kandler

  • 1Department of Neurology, The Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK. m.hadjivassiliou@sheffield.ac.uk

Journal of Neurology, Neurosurgery, and Psychiatry
|July 13, 2006
PubMed
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Gluten sensitivity is linked to many unexplained axonal neuropathies. This study found positive antigliadin antibodies in 34% of idiopathic neuropathy patients, suggesting a gluten-related cause.

Area of Science:

  • Neurology
  • Immunology
  • Gastroenterology

Background:

  • Axonal neuropathies are common, with many cases remaining idiopathic.
  • Positive antigliadin antibodies are associated with gluten sensitivity and celiac disease.

Purpose of the Study:

  • To investigate the characteristics and prevalence of axonal neuropathies linked to antigliadin antibodies.
  • To explore the role of gluten sensitivity in idiopathic axonal neuropathy.

Main Methods:

  • Prospective screening of 215 patients with peripheral neuropathy for antigliadin, antiendomysium, and tissue transglutaminase antibodies.
  • Clinical, neurophysiological, and neuropathological assessment of patients with positive antibody results.
  • Biopsy-confirmed diagnosis of celiac disease and assessment of human leukocyte antigen types.

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Main Results:

  • 34% of patients with idiopathic axonal neuropathy had positive antigliadin antibodies, compared to 12% in controls.
  • Celiac disease was diagnosed in at least 9% of idiopathic neuropathy patients.
  • Gluten-sensitive enteropathy was present in 29% of patients with gluten neuropathy.

Conclusions:

  • Gluten sensitivity is a potential etiological factor in a significant number of idiopathic axonal neuropathies.
  • Early identification and management of gluten sensitivity may improve outcomes for patients with unexplained neuropathy.