Gluten ataxia in Japan

Area of Science:

• Neurology
• Immunology
• Gastroenterology

Background:

• Gluten ataxia is a neurological disorder linked to gluten sensitivity.
• It has been considered rare in Asia compared to Western countries.
• Accurate diagnosis is essential for effective management.

Observation:

• This study investigated anti-deamidated gliadin peptide (DGP) antibody levels in 49 Japanese patients with cerebellar ataxia.
• Anti-DGP antibodies were detected in 16.3% of patients, indicating a higher prevalence than expected.
• Antibody subtypes included IgA, IgG, or both.

Findings:

• Treatment responses varied: intravenous immunoglobulin showed moderate effectiveness in some patients.
• Steroid therapy was ineffective in all patients.
• One patient experienced symptom improvement with a gluten-free diet alone.

Implications:

• The findings suggest gluten ataxia may be underdiagnosed in Asia.
• Routine screening for anti-DGP antibodies in Asian patients with cerebellar ataxia is recommended.
• Further research is needed to understand the prevalence and optimal treatment strategies in diverse populations.