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Peripheral Neurological Disturbances, Autonomic Dysfunction, and Antineuronal Antibodies in Adult Celiac Disease Before and After a Gluten-Free Diet

Digestive Diseases and Sciences volume 51, pages 1869–1874 (2006)Cite this article

Abstract

Thirty-two consecutive adult celiac disease (CD) patients (pts), complaining of peripheral neuropathy (12 pts), autonomic dysfunction (17 pts), or both (3 pts), were evaluated to assess the presence of neurological damage (by clinical neurological evaluation and electrophysiological study) and antineuronal antibodies and to assess the effect of a gluten-free diet (GFD) on the course of the neurological symptoms and on antineuronal antibodies. At entry, 12 of 32 (38%) pts showed signs and symptoms of neurological damage: 7 of 12 (58%), peripheral neurological damage; 3 of 12 (25%), autonomic dysfunction; and 2 (17%), both peripheral neurological damage and autonomic dysfunction. The overall TNS score was 105 at entry. Anti-GM1 antibodies were present in 5 of 12 (42%) pts: 3 showed peripheral neurological damage and 2 showed both peripheral neurological damage and autonomic dysfunction. One year after the GFD was started, histological lesions were still present in only 10 of 12 (83%) pts. TNS score was 99, 98, 98, and 101 at the 3rd, 6th, 9th, and 12th month after the GFD was started, so it did not improve throughout the follow-up. None of the pts showed disappearance of antineuronal antibodies throughout the follow-up. We conclude that adult CD patients may show neurological damage and presence of antineuronal antibodies. Unfortunately, these findings do not disappear with a GFD.

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Affiliations

  1. Digestive Endoscopy Unit, Lorenzo Bonomo Hospital, Andria, (BA), Italy

    Antonio Tursi

  2. Department of Internal Medicine, Clinical Nutrition Unit, S. Eugenio Hospital, Rome, Italy

    Gian Marco Giorgetti

  3. Division of Neurology, S. Eugenio Hospital, Rome, Italy

    Cesare Iani & Flavio Arciprete

  4. Department of Internal Medicine, Division of Gastroenterology, Cristo Re Hospital, Rome, Italy

    Giovanni Brandimarte

  5. Department of Internal Medicine and Immunology, Tor Vergata University, Rome, Italy

    Ambrogio Capria & Luigi Fontana

  6. Galleria Pisani 4, 70031, Andria, (BA), Italy

    Antonio Tursi

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  1. Antonio Tursi
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  2. Gian Marco Giorgetti
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  3. Cesare Iani
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  4. Flavio Arciprete
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  5. Giovanni Brandimarte
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  6. Ambrogio Capria
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  7. Luigi Fontana
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Correspondence to Antonio Tursi.

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Tursi, A., Giorgetti, G.M., Iani, C. et al. Peripheral Neurological Disturbances, Autonomic Dysfunction, and Antineuronal Antibodies in Adult Celiac Disease Before and After a Gluten-Free Diet. Dig Dis Sci 51, 1869–1874 (2006). https://doi.org/10.1007/s10620-005-9054-4

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  • DOI: https://doi.org/10.1007/s10620-005-9054-4

Keywords:

  • Antineuronal antibodies
  • Autonomic dysfunction
  • Celiac disease
  • Gluten-free diet
  • Peripheral neuropathy