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Gluten sensitivity and neuromyelitis optica: two case reports
  1. S Jacob1,
  2. M Zarei1,
  3. A Kenton2,
  4. H Allroggen2
  1. 1Department of Neurology, University Hospitals of Leicester NHS Trust, Royal Infirmary, Leicester LE1 5WW, UK
  2. 2Department of Neurology, University Hospitals of Coventry and Warwickshire NHS Trust, Walsgrave Hospital, Coventry CV2 2DX, UK
  1. Correspondence to:
 Dr Holger Allroggen
 Department of Neurology, Walsgrave Hospital, University Hospitals of Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK;


Neuromyelitis optica is a clinical syndrome characterised by acute transverse myelitis plus an acute or subacute optic neuritis with or without recovery. Although once believed to be a variant of multiple sclerosis, diagnostic criteria have recently been proposed for neuromyelitis optica, making it a clinically distinct syndrome. The term gluten sensitivity refers to a state of heightened immunological responsiveness to ingested gluten in genetically susceptible individuals, as indicated by circulating antibodies to gliadin. Several neurological complications have been described associated with gluten sensitivity ranging from peripheral neuropathy and cerebellar ataxia to an increased risk of epilepsy. Although myelopathy has been described in some case reports of coeliac disease, neuromyelitis optica has never been described in association with gluten sensitivity. We describe two cases of gluten sensitivity presenting as neuromyelitis optica with no previous history of significant gastrointestinal symptoms. Gluten sensitivity was confirmed by immunological and histological studies.

  • AGA, IgA anti-gliadin antibody
  • GGA, IgG anti-gliadin antibody
  • TTG, tissue transglutaminase antibody
  • gluten sensitivity
  • neuromyelitis optica
  • transverse myelitis

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  • Competing interests: none declared