scholarly journals Gluten Sensitivity Presenting as a Neuropsychiatric Disorder

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Stephen J. Genuis ◽  
Rebecca A. Lobo
Keyword(s):  
Scientific Literature ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Sole Source ◽  
Medical Community ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Neuropsychiatric Manifestations ◽  
History Of ◽  
Pathophysiologic Mechanisms

There has been increasing recognition in the medical community and the general public of the widespread prevalence of gluten sensitivity. Celiac disease (CD) was initially believed to be the sole source of this phenomenon. Signs and symptoms indicative of nonceliac gluten sensitivity (NCGS), in which classical serum and intestinal findings of CD may be absent, have been frequently reported of late. Clinical manifestations in patients with NCGS are characteristically triggered by gluten and are ameliorated or resolved within days to weeks of commencing a gluten-free diet. Emerging scientific literature contains several reports linking gluten sensitivity states with neuropsychiatric manifestations including autism, schizophrenia, and ataxia. A clinical review of gluten sensitivity is presented alongside a case illustrating the life-changing difference achieved by gluten elimination in a patient with a longstanding history of auditory and visual hallucinations. Physicians in clinical practice should routinely consider sensitivity issues as an etiological determinant of otherwise inexplicable symptoms. Pathophysiologic mechanisms to explain the multisystem symptomatology with gluten sensitivity are considered.

scholarly journals Movement Disorders Related to Gluten Sensitivity: A Systematic Review

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 1034 ◽  
Author(s):  
Ana Vinagre-Aragón ◽  
Panagiotis Zis ◽  
Richard Grunewald ◽  
Marios Hadjivassiliou
Keyword(s):  
Movement Disorders ◽  
Medical Literature ◽  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Inclusion Criteria ◽  
Pubmed Database ◽  
Gluten Sensitive Enteropathy ◽  
The Subject

Gluten related disorders (GRD) represent a wide spectrum of clinical manifestations that are triggered by the ingestion of gluten. Coeliac disease (CD) or gluten sensitive enteropathy is the most widely recognised, but extra-intestinal manifestations have also been increasingly identified and reported. Such manifestations may exist in the absence of enteropathy. Gluten sensitivity (GS) is another term that has been used to include all GRD, including those where there is serological positivity for GS related antibodies in the absence of an enteropathy. Gluten ataxia (GA) is the commonest extraintestinal neurological manifestation and it has been the subject of many publications. Other movement disorders (MDs) have also been reported in the context of GS. The aim of this review was to assess the current available medical literature concerning MDs and GS with and without enteropathy. A systematic search was performed while using PubMed database. A total of 48 articles met the inclusion criteria and were included in the present review. This review highlights that the phenomenology of gluten related MDs is broader than GA and demonstrates that gluten-free diet (GFD) is beneficial in a great percentage of such cases.

scholarly journals Clinical Characteristics and Management of 50 Patients with Anti-GAD Ataxia: Gluten-Free Diet Has a Major Impact

2020 ◽  
Author(s):  
M. Hadjivassiliou ◽  
P. G. Sarrigiannis ◽  
P. D. Shanmugarajah ◽  
D. S. Sanders ◽  
R. A. Grünewald ◽  
...  
Keyword(s):  
Autoimmune Diseases ◽  
Clinical Characteristics ◽  
Age At Onset ◽  
Gluten Free Diet ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Progressive Ataxia ◽  
Progressive Cerebellar Ataxia ◽  
Limb Ataxia ◽  
History Of

Abstract The objective of this study is to report the clinical characteristics and treatment of patients with progressive cerebellar ataxia associated with anti-GAD antibodies. We performed a retrospective review of all patients with anti-GAD ataxia managed at the Sheffield Ataxia Centre over the last 25 years. We identified 50 patients (62% females) with anti-GAD ataxia. The prevalence was 2.5% amongst 2000 patients with progressive ataxia of various causes. Mean age at onset was 55 and mean duration 8 years. Gaze-evoked nystagmus was present in 26%, cerebellar dysarthria in 26%, limb ataxia in 44% and gait ataxia in 100%. Nine patients (18%) had severe, 12 (24%) moderate and 29 (58%) mild ataxia. Ninety percent of patients had a history of additional autoimmune diseases. Family history of autoimmune diseases was seen in 52%. Baseline MR spectroscopy of the vermis was abnormal at presentation in 72%. Thirty-five patients (70%) had serological evidence of gluten sensitivity. All 35 went on gluten-free diet (GFD). Eighteen (51%) improved, 13 (37%) stabilised, 3 have started the GFD too recently to draw conclusions and one deteriorated. Mycophenolate was used in 16 patients, 7 (44%) improved, 2 stabilised, 6 have started the medication too recently to draw conclusions and one did not tolerate the drug. There is considerable overlap between anti-GAD ataxia and gluten ataxia. For those patients with both, strict GFD alone can be an effective treatment. Patients with anti-GAD ataxia and no gluten sensitivity respond well to immunosuppression.

scholarly journals CRANIOVERTEBRAL ABNORMALITIES: THE SYSTEMATIZATION PRINCIPLES,THEORIES, CLINICAL MANIFESTATIONS (LITERATURE REVIEW)

2014 ◽  
Vol 6 (4) ◽  
pp. 86-93
Author(s):  
S V Lobzin ◽  
E A Yurkina
Keyword(s):  
Literature Review ◽  
Scientific Literature ◽  
Clinical Manifestations ◽  
History Of Research ◽  
History Of

The authors analysis of the scientific literature on the problem of craniovertebral abnormalities has been conducted. In this article the history of research on craniovertebral abnormalities, the classification, theories of pathogenesis have been described.

scholarly journals Severe primary hypothyroidism in an apparently asymptomatic 19-year-old woman: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Rania Dannan ◽  
Sulaiman Hajji ◽  
Khaled Aljenaee
Keyword(s):  
Incidental Finding ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Thyroid Stimulating Hormone ◽  
Primary Hypothyroidism ◽  
Conflicting Evidence ◽  
Thyroid Function Testing ◽  
History Of ◽  
Asymptomatic Individuals ◽  
High Index Of Suspicion

Abstract Background Hypothyroidism is diagnosed on the basis of laboratory tests because of the lack of specificity of the typical clinical manifestations. There is conflicting evidence on screening for hypothyroidism. Case presentation We report a case of an apparently healthy 19-year-old Kuwaiti woman referred to our clinic with an incidental finding of extremely high thyroid-stimulating hormone (TSH), tested at the patient’s insistence as she had a strong family history of hypothyroidism. Despite no stated complaints, the patient presented typical symptoms and signs of hypothyroidism on evaluation. Thyroid function testing was repeated by using different assays, with similar results; ultrasound imaging of the thyroid showed a typical picture of thyroiditis. Treatment with levothyroxine alleviated symptoms and the patient later became biochemically euthyroid on treatment. Conclusion There is controversy regarding screening asymptomatic individuals for hypothyroidism; therefore, it is important to maintain a high index of suspicion when presented with mild signs and symptoms of hypothyroidism especially with certain ethnic groups, as they may be free of the classical symptoms of disease.

scholarly journals Fahr’s syndrome and idiopathic hypoparathyroidism: A case report

2017 ◽  
Vol 74 (2) ◽  
pp. 184-188 ◽  
Author(s):  
Dejan Marinkovic ◽  
Tamara Dragovic ◽  
Sasa Kikovic ◽  
Snezana Kuzmic-Jankovic ◽  
Zorana Djuran ◽  
...  
Keyword(s):  
Case Report ◽  
Basal Ganglia ◽  
Neurodegenerative Disorder ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Intravenous Rehydration ◽  
Fahr’S Syndrome ◽  
Appropriate Treatment ◽  
Brain Calcification ◽  
Neuropsychiatric Manifestations

Introduction. Fahr?s syndrome is a rare, slowly progressive, neurodegenerative disorder, characterised by extensive, bilateral, and symmetrical basal ganglia calcification. It is associated with neuropsychiatric manifestations and gradually progressive cognitive impairment. Fahr's syndrome is the secondary form of brain calcification that is caused by various metabolic, infectious, or degenerative diseases. Case report. We presented a middle-aged male with Fahr's syndrome due to primary idiopathic hypoparathyroidism. Clinical diagnosis was based on signs and symptoms of hypocalcemia, progressive neuropsychiatric illnesses, laboratory evidence of hypoparathyroidism, and radiological signs of calcifications in the basal ganglia. The patient improved after only a few days of intravenous rehydration and calcium substitution, followed by oral supplemental calcitriol. Conclusion. Timely recognition of idiopathic and iatrogenic hypoparathyroidism allows appropriate treatment that can prevent the development and clinical manifestations of Fahr?s syndrome and potentially slow its progression.

scholarly journals Right Cerebellar Tuberculosis with Cranial Nerve Palsy in Pulmonary Tuberculosis Patient

2021 ◽  
Vol 7 (2) ◽  
pp. 65
Author(s):  
I Komang Rusgi Yandi ◽  
Isnin Anang Marhana
Keyword(s):  
Young Adult ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Tuberculosis Patient ◽  
Public Health Issue ◽  
High Morbidity ◽  
Radiological Findings ◽  
Blurred Vision ◽  
History Of

Introduction: Tuberculosis (TB) is a major public health issue. The most devastating clinical manifestations of TB is Central nervous system (CNS) TB. CNS TB is found approximately in 1% of all patients with active TB, and cerebellar TB is rarely reported. CNS TB can present as meningitis, arachnoiditis, tuberculomas, or the uncommon forms of tuberculous subdural empyema and brain abscess.Case: A 23-year-old patient was reported in October 2018 with signs and symptoms of 2-month history of vertigo, headache, vomiting, weakness, fever, blurred vision, lingual palsy, dysmetria, and decrease of consciousness. The patient had a few months of history of cough, contact with a TB patient, his father, and loss of body weight. On admission, the patient had fever (38.50 C) and Glasgow coma score of 13.Discussion:  CNS TB can occur in an immunocompromised patient with malnutrition, whether a child or young adult. The patient in this case had risk factors because he is a young adult and had contact with a patient of TB, his father. Based on epidemiology, clinical signs and symptoms, radiological findings, and the result of AFB-stained sputum, the patient was diagnosed with right cerebellar TB and PTB.Conclusion: The high morbidity and mortality characteristics of CNS TB are very important to note, thus the prompt diagnosis and therapy should be done. The specific therapy of ATD combined with surgery seems to provide a good result. The clinical and radiological findings were used as the evaluation of the medication.

scholarly journals MUCOPOLYSACARIDOSIS TYPE IIIB MISDIAGNOSED AS AN AUTISTIC SPECTRUM DISORDER: A CASE REPORT AND LITERATURE REVIEW

2021 ◽  
Vol 39 ◽  
Author(s):  
Alan Tibério Dalpiaz Irigonhê ◽  
Angélica Malman Thomazine Moreira ◽  
Daniel Almeida do Valle ◽  
Mara Lúcia Schmitz Ferreira Santos
Keyword(s):  
Rare Case ◽  
Autistic Spectrum Disorder ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Behavioral Changes ◽  
Case Description ◽  
Diagnostic Challenge ◽  
Metabolic Investigation ◽  
History Of ◽  
Established Treatment

ABSTRACT Objective: To report a rare case of mucopolysaccharidosis IIIB in a pediatric patient, with emphasis on the description of the clinical manifestations and the early diagnosis. Case description: A 14-year-old male patient, who presented regression of neuropsychomotor development since his three years and six months old, with speech loss and frequent falls, evolving with behavioral changes, with agitation and aggressiveness. Although being diagnosed with autism, there was no response to the established treatment; he was subsequently submitted to metabolic investigation, which lead to the diagnosis of Mucopolysaccharidosis IIIB. Comments: Identifying a metabolic disorder requires connecting multiple signs and symptoms, as well as eliminating other apparent causes. MPS IIIB is a diagnostic challenge, particularly in the early stages and in the absence of a family history of the disease.

scholarly journals Rare Skeletal Complications in the Setting of Primary Hyperparathyroidism

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Nikos Sabanis ◽  
Eleni Gavriilaki ◽  
Eleni Paschou ◽  
Asterios Kalaitzoglou ◽  
Dimitrios Papanikolaou ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Holistic Approach ◽  
Unique Case ◽  
Skeletal Involvement ◽  
Asymptomatic Patients ◽  
Skeletal Complications ◽  
History Of ◽  
Recurrent Nephrolithiasis ◽  
Previous Medical History

Parathyroid carcinoma represents an extremely rare neoplasm with diverse clinical manifestations which vary from asymptomatic patients to severe complications of hypercalcemia or parathyrotoxicosis while skeletal involvement is rather common. Herein we aimed at presenting a unique case of a young patient with rare aggressive skeletal complications of parathyroid cancer that initially were misdiagnosed. Ossification of the cervical ligamentum flavum and skull tumor illustrates erosive bonny lesions of hyperparathyroidism that in association with previous medical history of recurrent nephrolithiasis and biochemical findings guide the diagnosis. We suggest that increased awareness and holistic approach are needed in order to recognize and further investigate signs and symptoms of hyperparathyroidism.

Neuropsychiatric manifestations of vitamin B12 and folate deficiencies: Data from an inpatient psychiatric department

2016 ◽  
Vol 33 (S1) ◽  
pp. S371-S371
Author(s):  
A. Mota ◽  
M. Lázaro ◽  
R. Alves ◽  
A. Moreira ◽  
M. Nobre
Keyword(s):  
Vitamin B12 ◽  
Scientific Literature ◽  
Case Series ◽  
Signs And Symptoms ◽  
Routine Screening ◽  
Blood Tests ◽  
Neuropsychiatric Manifestations ◽  
B12 Deficiency ◽  
Competing Interest ◽  
Psychiatric Department

IntroductionThe prevalence of vitamin B12 and folate deficiency is significant in the psychiatric population. These deficiencies may be associated with varied neuropsychiatric signs and symptoms, caused by different pathophysiological mechanisms.ObjectivesCharacterize the main neuropsychiatric signs and symptoms associated with vitamin B12 and folate deficiencies. Evaluate the prevalence of these vitamins deficiencies in an acute inpatient psychiatric department, dedicated to Affective Disorders.AimsTo review the clinical significance of vitamin B12 and folate deficiencies in psychiatric disorders and reflect on the importance of routine screening in mental health care.Material and methodsObservational, retrospective and descriptive study, with analysis of clinical and blood tests data concerning the total number of inpatient episodes in 2015. Non-systematic review of the scientific literature.ResultsA small case series of the patients that had folate or B12 deficiency detected is presented. The prevalence of vitamin B12 and folate deficiencies found in our study is in accordance with the data found in the literature.ConclusionsVitamin B12 and folate deficiencies should be considered in the approach to the psychiatric patient as its neuropsychiatric manifestations are varied, can be severe, and may constitute a potentially treatable cause of mental disorder. Our data shows that folate and B12 deficiencies are significant in inpatients and we believe it justifies routine screening at admission.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Primer on Multiple Sclerosis

2016 ◽  
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Care Professionals ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Diagnostic Strategies ◽  
History Of ◽  
Clinical Signs And Symptoms ◽  
Nursing Health

Primer on Multiple Sclerosis, second edition is designed to be a practical guide to the basic science and clinical manifestations of multiple sclerosis. It is intended primarily for neurologists and other health care professionals who treat persons with this disease. The book starts with a review of the history of multiple sclerosis and the basic genetics, immunology, electrophysiology, and pathophysiology that are central to the disease. It then reviews the common and uncommon clinical signs and symptoms of multiple sclerosis and the management of these conditions. The latest diagnostic strategies are presented. There is extensive coverage of approved and experimental disease-modifying therapies, including algorithms to assist clincians in choosing these therapies. Complementary and alternative therapies that are popular among persons with multiple sclerosis are examined. New additions to this edition include a chapter for nursing health care professionals, and updates on therapeutics. Unique to this book are the chapters on the legal, psychosocial, and vocational issues that often present challenges for person with multiple sclerosis, topics that typically are not covered in standard texts.

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