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Celiac disease with neurologic manifestations in children

Georgeta Diaconu1, M Burlea1, Ioana Grigore1

  • 1Department of Pediatrics, Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, Iaşi.

Revista Medico-Chirurgicala a Societatii De Medici Si Naturalisti Din Iasi
|February 11, 2014
PubMed

Insights

Neurologic symptoms are common in children with celiac disease (CD). Early diagnosis and gluten-free diet are crucial for managing these manifestations.

Area of Science:

  • Pediatric Neurology
  • Gastroenterology
  • Immunology

Background:

  • Celiac disease (CD) is an immune-mediated enteropathy.
  • Neurologic manifestations can be a presenting feature of CD in children.
  • Genetic susceptibility plays a role in CD development.

Purpose of the Study:

  • To determine the incidence of neurologic manifestations in children diagnosed with celiac disease.
  • To document the types and frequency of neurologic symptoms in pediatric CD patients.
  • To assess the impact of a gluten-free diet on neurologic symptoms in children with CD.

Main Methods:

  • A cohort of 48 children (aged 2-18 years) diagnosed with CD between 2000-2010 were monitored.
  • CD diagnosis confirmed via serological tests and intestinal biopsy.
  • Evaluations included physical measurements, biological/immunological tests, histology, parent questionnaires on development/neurologic signs, psychological exams, EEG, and brain CT scans.

Main Results:

  • 16 out of 48 children (33.3%) presented with one or more neurologic symptoms at CD onset.
  • Most frequent symptoms included headache/migraine, ADHD, epilepsy, mental retardation, cerebellar ataxia, and behavioral disorders.
  • Brain imaging revealed cerebral calcifications in 3 epileptic patients and atrophy in 2 with cerebellar ataxia. Gluten-free diet improved migraine and epilepsy symptoms but not others.

Conclusions:

  • Celiac disease presents with a wide spectrum of neurologic symptoms in pediatric patients.
  • Neurologic symptoms of unknown etiology, especially those resistant to treatment, warrant consideration of celiac disease.
  • Diagnostic workup for suspected CD should include immunological tests and intestinal biopsy.
Abstract

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