Neurological Manifestations of Gastrointestinal and Hepatic Diseases

2017 ◽  
Author(s):  
Brian P. Bosworth ◽  
Brian R. Landzberg ◽  
Elisa McEachern
Keyword(s):  
Celiac Disease ◽  
Peripheral Neuropathy ◽  
Liver Diseases ◽  
Acute Intermittent Porphyria ◽  
Gluten Sensitivity ◽  
Neurological Manifestations ◽  
Gluten Ataxia ◽  
Hepatic Diseases ◽  
Digestive Diseases ◽  
Inflammatory Bowel

Digestive diseases may have protean neurological manifestations, and should be considered during neurological evaluation of patients. Neurological manifestations of celiac disease (CD) may involve both central and peripheral nervous system, including syndromes of cerebellar and myoclonic ataxia, encephalopathy and dementia, seizures, CNS vasculitis and progressive multifocal leukoencephalopathy, peripheral neuropathy, and myopathy. Gluten sensitivity has been frequently implicated as a cause of neuropathy, with up to 49% of celiac disease patients experiencing some form of neuropathy and almost 40% meeting the criteria for peripheral neuropathy. Gluten ataxia is one of the most common neurological manifestations of celiac disease. Neurologic manifestations of inflammatory bowel disease (IBD) have long been recognized, with an incidence ranging from less than 1% to 35%. These manifestations may precede or, more commonly, follow a diagnosis of IBD. Hepatic encephalopathy, Wilson’s disease, and acute intermittent porphyria are examples of liver diseases associated with hepatic disorders.

Gluten ataxia is better classified as non-celiac gluten sensitivity than as celiac disease: a comparative clinical study

2015 ◽  
Vol 64 (2) ◽  
pp. 558-564 ◽  
Author(s):  
Luis Rodrigo ◽  
Carlos Hernández-Lahoz ◽  
Eugenia Lauret ◽  
Maria Rodriguez-Peláez ◽  
Miroslav Soucek ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Clinical Study ◽  
Gluten Sensitivity ◽  
Gluten Ataxia ◽  
Comparative Clinical Study

scholarly journals Gluten-related disorders

2021 ◽  
pp. 100-100
Author(s):  
Biljana Vuletic ◽  
Aleksandar Kocovic ◽  
Marija Mladenovic ◽  
Zoran Lekovic ◽  
Vladimir Radlovic ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Clinical Features ◽  
Dermatitis Herpetiformis ◽  
Current Knowledge ◽  
Diagnosis And Treatment ◽  
Gluten Sensitivity ◽  
Wheat Allergy ◽  
Clinical Expression ◽  
Barley Flour ◽  
Gluten Ataxia

Gluten-related disorders are a heterogeneous group of clinical entities caused by intolerance of wheat, rye, and barley flour components. They occur in 3-5% of genetically predisposed persons and based on pathogenic and clinical features are classified into celiac disease, non-celiac gluten sensitivity, and wheat allergy. There are also specific entities such as dermatitis herpetiformis or gluten ataxia, which can occur either within the celiac disease or independently. This article based on the current knowledge shows the basic details of the pathogenesis, clinical expression, diagnosis, and treatment of these disorders.

scholarly journals Neurological Manifestations of Neuropathy and Ataxia in Celiac Disease: A Systematic Review

Nutrients ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 380 ◽  
Author(s):  
Elizabeth Mearns ◽  
Aliki Taylor ◽  
Kelly Thomas Craig ◽  
Stefanie Puglielli ◽  
Daniel Leffler ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Gastrointestinal Disorder ◽  
Neurological Manifestation ◽  
Cochrane Library ◽  
Unknown Etiology ◽  
Neurological Manifestations ◽  
Gluten Ataxia ◽  
Immune Mediated ◽  
Increased Risk ◽  
The Cochrane Library

Celiac disease (CD) is an immune-mediated gastrointestinal disorder driven by innate and adaptive immune responses to gluten. Patients with CD are at an increased risk of several neurological manifestations, frequently peripheral neuropathy and gluten ataxia. A systematic literature review of the most commonly reported neurological manifestations (neuropathy and ataxia) associated with CD was performed. MEDLINE, Embase, the Cochrane Library, and conference proceedings were systematically searched from January 2007 through September 2018. Included studies evaluated patients with CD with at least one neurological manifestation of interest and reported prevalence, and/or incidence, and/or clinical outcomes. Sixteen studies were included describing the risk of gluten neuropathy and/or gluten ataxia in patients with CD. Gluten neuropathy was a neurological manifestation in CD (up to 39%) in 13 studies. Nine studies reported a lower risk and/or prevalence of gluten ataxia with a range of 0%–6%. Adherence to a gluten-free diet appeared to improve symptoms of both neuropathy and ataxia. The prevalence of gluten neuropathy and gluten ataxia in patients with CD varied in reported studies, but the increased risk supports the need for physicians to consider CD in patients with ataxia and neurological manifestations of unknown etiology.

scholarly journals Commentary: “Gluten Ataxia and their relationships with Celiac Disease and Non-Celiac Gluten Sensitivity”

2018 ◽  
Vol 1 (1) ◽  
pp. 01-02
Author(s):  
Luis Rodrigo
Keyword(s):  
Celiac Disease ◽  
Postural Balance ◽  
Clinical Entity ◽  
Common Denominator ◽  
Gluten Sensitivity ◽  
Gluten Ataxia ◽  
The Brain ◽  
Permanent Presence

The word "ataxia" means etymologically, incoordination or clumsiness. It is a symptom, not a diagnosis in itself, or a clinical entity. The diseases that present it, have as a common denominator, the permanent presence of a progressive alteration of the balance, more evident when standing and walking, together with a lack of coordination of the extremities with movement, all accompanied by disorders of the language, consisting of a difficulty in pronouncing well, having to work much harder than usual, to achieve an understanding, especially with difficult words, or in prolonged conversations. The underlying lesion is located mainly at the level of the cerebellum, which is the part of the brain responsible for coordinating movements and the center of postural balance, as well as the language.

scholarly journals The Characterization of the Repertoire of Wheat Antigens and Peptides Involved in the Humoral Immune Responses in Patients with Gluten Sensitivity and Crohn's Disease

ISRN Allergy ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-12 ◽  
Author(s):  
Aristo Vojdani
Keyword(s):  
Crohn’S Disease ◽  
Celiac Disease ◽  
Crohn's Disease ◽  
Gluten Sensitivity ◽  
Humoral Immune ◽  
Humoral Immune Responses ◽  
Iga Antibodies ◽  
Healthy Control ◽  
Iga Response ◽  
Inflammatory Bowel

Intestinal T cells from gluten sensitivity/celiac disease patients respond to a heterogeneous array of peptides. Our study extended this heterogeneity to humoral immune response to various wheat proteins and peptides in patients with gluten sensitivity or Crohn’s disease. IgG and IgA antibodies in sera from those patients and healthy control subjects were measured against an array of wheat antigens and peptides. In gluten-sensitive patients, IgG reacted most against transglutaminase, prodynorphin, wheat extract, and -, -, and -gliadin; IgA reacted most against wheat then transglutaminase, glutenin, and other peptides. In the sera of Crohn’s disease patients, IgG reacted most against wheat and wheat germ agglutinin then transglutaminase, prodynorphin, -, and -gliadin; IgA reacted foremost against prodynorphin then transglutaminase and -gliadin. These results showed a substantial heterogeneity in the magnitude of IgG and IgA response against various wheat antigens and peptides. Measurements of IgG and IgA antibodies against such an array of wheat peptides and antigens can enhance the sensitivity and specificity of serological assays for gluten sensitivity and celiac disease and may also detect silent celiac disease or its overlap with inflammatory bowel disease.

Celiac Disease

2013 ◽  
Author(s):  
Aaron E. Miller ◽  
Teresa M. DeAngelis
Keyword(s):  
Celiac Disease ◽  
Sensory Neuropathy ◽  
Neurological Involvement ◽  
Neurological Manifestations ◽  
Peripheral Sensory Neuropathy ◽  
Gluten Ataxia ◽  
Serologic Tests ◽  
Controversial Topic ◽  
Peripheral Sensory ◽  
Therapeutic Responses

Neurological involvement of celiac disease is a controversial topic and estimated to occur in 6-10% of patients. Cerebellar (‘gluten’) ataxia and peripheral sensory neuropathy are the most common neurological manifestations of celiac disease. In this chapter, we review the multiple neurological manifestations of celiac disease, the utility of available diagnostic serologic tests, and the variable therapeutic responses to gluten restriction diets.

Are Viruses and Parasites Linked to Celiac Disease? A Question that Still has no Definite Answer

2019 ◽  
Vol 20 (14) ◽  
pp. 1181-1193 ◽  
Author(s):  
Aref Shariati ◽  
Hamid R. Aslani ◽  
Mohammad R.H. Shayesteh ◽  
Ali Taghipour ◽  
Ahmad Nasser ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Multiple Roles ◽  
Barr Virus ◽  
The People ◽  
Intestinal Infections ◽  
Inflammatory Bowel ◽  
Epstein Barr ◽  
Irritable Bowel ◽  
Related Proteins

Celiac Disease (CD) is a complex autoimmune enteropathy of the small intestine that commonly occurs in genetically predisposed individuals due to intake of gluten and related proteins. Gluten consumption, duration of breast-feeding, various infections, especially frequent intestinal infections, vaccinations and use of antibiotics can be linked to CD. It is predicted that it affects 1% of the global population and its incidence rate is increasing. Most of the people with the HLA-DQ2 or HLADQ8 are at a higher risk of developing this disease. The link between infections and autoimmune diseases has been very much considered in recent years. In several studies, we explained that pathogenic and non-pathogenic microorganisms might have multiple roles in initiation, exacerbation, and development of Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD). In various studies, the relationship between infections caused by viruses, such as Epstein-Barr Virus (EBV), Rotavirus, Hepatitis C (HCV), Hepatitis B virus (HBV), Cytomegalovirus (CMV), and Influenza virus, and parasites including Giardia spp. and Toxoplasma gondii with CD has been raised. However, increasing evidence proposes that some of these microorganisms, especially helminths, can also have protective and even therapeutic roles in the CD process. Therefore, in order to determine the role of microorganisms in the process of this disease, we attempted to summarize the evidence suggesting the role of viral and parasitic agents in pathogenesis of CD.

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