Neuromyelitis optica (NMO) is a severe inflammatory disorder of the CNS of putative autoimmune aetiology, which predominantly affects optic nerves and spinal cord. Gluten sensitivity refers to an autoimmune condition characterised by the presence of antibodies to tissue transglutaminase usually associated with gastrointestinal symptoms. However, neurological complications associated with gluten sensitivity, ranging from peripheral neuropathy to inflammatory brain lesions mimicking multiple sclerosis (MS), have been described. In a recent case report, published in this journal, some of us reported on the first and, to our knowledge, so far the only cases of serologically and histologically confirmed gluten sensitivity and NMO.1

A major …