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Autonomic imbalance in celiac children.
Minerva Pediatrica
|October 14, 2010
Summary
Celiac disease in children shows an enhanced sympathetic tone, even after a gluten-free diet. While gastrointestinal symptoms resolve, this autonomic imbalance persists, suggesting a complex underlying mechanism.
Area of Science:
- Pediatric Gastroenterology
- Autonomic Neurology
- Immunology
Background:
- Celiac disease (CD) involves multiple organ systems, including the nervous system.
- Autonomic neuropathy is documented in adult celiac patients, but its status in children is unexamined.
- Evaluating autonomic function is crucial for a comprehensive understanding of pediatric celiac disease.
Purpose of the Study:
- To investigate autonomic nervous system function in children diagnosed with celiac disease.
- To assess changes in autonomic function after adherence to a gluten-free diet (GFD).
Main Methods:
- Fifteen children with untreated celiac disease and fifteen healthy controls were recruited.
- Autonomic function was evaluated using heart rate variability (HRV) indexes.
- Serum markers, including anti-tissue transglutaminase (anti-tTG) and anti-ganglioside antibodies, were measured at baseline and after 24 months on a GFD.
Main Results:
- Children with celiac disease exhibited an imbalance in the neurovegetative system, characterized by a predominant sympathetic tone.
- This sympathetic predominance persisted even after 24 months of GFD.
- Gastrointestinal symptoms resolved with the GFD, suggesting the sympathetic tone is not the primary cause of these symptoms.
Conclusions:
- Pediatric celiac disease is associated with persistent sympathetic hyperactivity, independent of gastrointestinal symptom resolution.
- The underlying cause of this sustained autonomic dysfunction in pediatric celiac disease remains undetermined.
- Further research is needed to elucidate the pathogenesis of autonomic dysfunction in celiac disease.
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