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Neuropathy associated with gluten sensitivity
  1. M Hadjivassiliou1,
  2. R A Grünewald1,
  3. R H Kandler2,
  4. A K Chattopadhyay2,
  5. J A Jarratt2,
  6. D S Sanders4,
  7. B Sharrack1,
  8. S B Wharton3,
  9. G A B Davies-Jones1
  1. 1Department of Neurology, The Royal Hallamshire Hospital, Sheffield, UK
  2. 2Department of Neurophysiology, The Royal Hallamshire Hospital
  3. 3Department of Neuropathology, The Royal Hallamshire Hospital
  4. 4Department of Gastroenterology, The Royal Hallamshire Hospital
  1. Correspondence to:
 M Hadjivassiliou
 Department of Neurology, The Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK; m.hadjivassiliou{at}sheffield.ac.uk

Abstract

Objectives: To prospectively study the clinical, neurophysiological and neuropathological characteristics of axonal neuropathies associated with positive antigliadin antibodies and the prevalence of such neuropathies in a cohort of patients with sporadic axonal neuropathy.

Methods: Prospective screening (using antigliadin, antiendomysium and tissue transglutaminase antibodies) of patients with peripheral neuropathy attending a neurology clinic.

Results: 215 patients with axonal neuropathy were screened. 141 patients had symmetrical sensorimotor neuropathy, 47 had mononeuropathy multiplex, 17 had motor neuropathy and 10 had small-fibre neuropathy. Despite extensive investigations of the 215 patients, 140 had idiopathic neuropathy. Positive immunoglobulin (Ig)G with or without IgA antigliadin antibodies was found in 34% (47/140) of the patients with idiopathic neuropathy. This compares with 12% prevalence of these antibodies in the healthy controls. The prevalence of coeliac disease as shown by biopsy in the idiopathic group was at least 9% as compared with 1% in the controls. The clinical features of 100 patients (47 from the prevalence study and 53 referred from elsewhere) with gluten neuropathy included a mean age at onset of 55 (range 24–77) years and a mean duration of neuropathy of 9 (range 1–33) years. Gluten-sensitive enteropathy was present in 29% of patients. The human leucocyte antigen types associated with coeliac disease were found in 80% of patients.

Conclusions: Gluten sensitivity may be aetiologically linked to a substantial number of idiopathic axonal neuropathies.

  • HLA, human leucocyte antigen

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Footnotes

  • Published Online First 11 July 2006

  • Competing interests: None.

  • Ethical approval: The South Sheffield Research Ethics Committee approved the study protocol, and all patients provided written informed consent.

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