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Celiac disease, brain atrophy, and dementia
P Collin1, T Pirttilä, T Nurmikko
1Department of Internal Medicine, Tampere University Central Hospital, Finland.
Neurology
|March 1, 1991
Summary
Celiac disease (CD) can cause dementia before age 60, even with mild digestive issues. Early diagnosis is crucial, though a gluten-free diet may not reverse neurological damage.
Area of Science:
- Neurology
- Gastroenterology
- Immunology
Background:
- Celiac disease (CD) is an autoimmune disorder typically associated with gastrointestinal symptoms.
- Presenile dementia affects individuals under 60 and has diverse etiologies.
- The link between celiac disease and neurological disorders is increasingly recognized.
Observation:
- Five patients presented with dementia before age 60.
- Neurological examination revealed moderate to severe intellectual deterioration.
- Brain imaging showed diffuse cerebral or cerebellar atrophy in affected patients.
Findings:
- Celiac disease diagnosis was confirmed via jejunal biopsy (subtotal villous atrophy) and positive serum antibodies (reticulin, gliadin).
- Notably, gastrointestinal symptoms were minimal in these patients.
- A gluten-free diet provided neurological improvement in only one patient.
Implications:
- Celiac disease should be considered in the differential diagnosis of presenile dementia.
- The multisystemic nature of CD extends to neurological manifestations.
- Immunologic pathways are suspected contributors to CD-associated cognitive decline, warranting further investigation.