scholarly journals Proximal Limb Weakness in a Patient with Celiac Disease: Copper Deficiency, Gluten Sensitivity, or Both as the Underlying Cause?

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
J. David Avila ◽  
David Lacomis
Keyword(s):  
Celiac Disease ◽  
Copper Deficiency ◽  
Gastrointestinal Symptoms ◽  
Gluten Sensitivity ◽  
Micronutrient Deficiencies ◽  
Limb Weakness ◽  
Neurologic Disorders ◽  
Copper Supplementation ◽  
Autoimmune Conditions ◽  
Untreated Celiac Disease

Celiac disease has been associated with several neurologic disorders which may result from micronutrient deficiencies, coexisting autoimmune conditions, or gluten sensitivity. Copper deficiency can produce multiple neurologic manifestations. Myeloneuropathy is the most common neurologic syndrome and it is often irreversible, despite copper replacement. We report the case of a 55-year-old man who presented with progressive proximal limb weakness and weight loss in the setting of untreated celiac disease without gastrointestinal symptoms. He had anemia, neutropenia, and severe hypocupremia. The pattern of weakness raised the suspicion that there was an underlying myopathy, although this was not confirmed by electrodiagnostic studies. Weakness and hematologic abnormalities resolved completely within 1 month of total parenteral nutrition with copper supplementation and a gluten-free diet. Myopathy can rarely occur in patients with celiac disease, but the mechanism is unclear. Pure proximal limb weakness has not been previously reported in copper deficiency. We propose that this may represent a novel manifestation of hypocupremia and recommend considering copper deficiency and gluten sensitivity in patients presenting with proximal limb weakness.

scholarly journals The impact of gluten ingestion on pathogenesis of neurological disorders

2019 ◽  
Vol 73 ◽  
pp. 197-216
Author(s):  
Piotr Grzegrzółka ◽  
Robert Jarzyna
Keyword(s):  
Autism Spectrum Disorder ◽  
Nervous System ◽  
Celiac Disease ◽  
Human Body ◽  
Neurological Disorders ◽  
Gastrointestinal Symptoms ◽  
Autism Spectrum ◽  
Gluten Sensitivity ◽  
Wheat Allergy ◽  
The Impact

For many years the spectrum of gluten-related disorders had been limited only to celiac disease and its typical gastrointestinal symptoms. In the last few years, not only new disorders like non-celiac gluten sensitivity have been described, but also pathogeneses of celiac disease and wheat allergy have been better understood. It is also known that impaired gluten tolerance in many cases leads to appearance of extraintestinal symptoms that may affect any organ or system of the human body including the nervous system that may be the cause of some neurological disorders such as ataxia, neuropathy, autism spectrum disorder (ASD) or schizophrenia. In this paper we present the spectrum of neurological disorders, whose pathogeneses may depend on gluten ingestion and some proposed mechanisms elucidating those pathogeneses.

scholarly journals Nonceliac Gluten Sensitivity—A Masquerading IBS or a Real Phenomenon?

2020 ◽  
Vol 2 (2) ◽  
pp. 118-122
Author(s):  
Yoram Elitsur ◽  
Deborah Preston
Keyword(s):  
Celiac Disease ◽  
Neuropsychiatric Symptoms ◽  
Symptom Relief ◽  
Gastrointestinal Symptoms ◽  
Gluten Sensitivity ◽  
Clinical Criteria ◽  
Real Phenomenon ◽  
Clinical Phenomenon ◽  
Irritable Bowel ◽  
New Diagnosis

The gluten-free diet has become popular among the public. People who are using this diet have reported symptom relief once gluten has been removed from their diet. Nonceliac gluten sensitivity (NCGS) has emerged as a new diagnosis for those patients who have tested negative for celiac disease. Although there are no diagnostic markers established for NCGS, its symptomatology ranges from gastrointestinal symptoms to neuropsychiatric symptoms. Indeed, some of these symptoms are also seen in patients with irritable bowel syndrome (IBS), such as abdominal pain, bloating, altered bowel movement, diarrhea, and constipation. It is important to add that unlike celiac disease, NGCS has never been associated with any long-term malignancy. We aim to review the recent clinical data available on this topic and address the overlap symptoms between NCGS and IBS. We concluded that despite the overlap symptoms between both diseases, NCGS is a real clinical phenomenon that awaits its own diagnostic clinical criteria and specific laboratory markers. We suggest that patients with gluten sensitivity who are negative for celiac disease should be considered for NCGS.

Abstract #337: A Rare Case of Copper Deficiency and Celiac Disease

2006 ◽  
Vol 12 ◽  
pp. 96-97
Author(s):  
Mihaela Cosma ◽  
Daniel L. Hurley
Keyword(s):  
Celiac Disease ◽  
Rare Case ◽  
Copper Deficiency

Celiac Disease in Kosovar Albanian Children: Evaluation of Clinical Features and Diagnosis

2020 ◽  
Vol 16 (3) ◽  
pp. 241-247
Author(s):  
Atifete Ramosaj-Morina ◽  
Alije Keka-Sylaj ◽  
Arbana Baloku Zejnullahu ◽  
Lidvana Spahiu ◽  
Virgjina Hasbahta ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Dominant Mode ◽  
Primary School Children ◽  
Cross Sectional ◽  
Classical Form ◽  
Wide Range ◽  
The Mean

Background: Celiac disease is an immune-mediated disorder characterized by variable clinical manifestations, specific antibodies, HLA-DQ2/DQ8 haplotypes, and enteropathy. Objectives: The aim of this study was to present the clinical spectrum and patterns of celiac disease in Kosovar Albanian children. Methods: A cross-sectional retrospective study was performed with Albanian children aged 0-18 years, treated for celiac disease in the Pediatric Clinic, University Clinical Center of Kosovo from 2005 to 2016. Results: During the study period, 63 children were treated for celiac disease. The mean age at diagnosis was 5.5 years (SD ± 3.31). The mean age at celiac disease onset was 3.3 years (SD ± 2.02), while the mean delay from the first symptoms indicative of celiac disease to diagnosis was 2.2 years (SD ± 2.09). More than 70% of the patients were diagnosed in the first 7 years of life, mainly presented with gastrointestinal symptoms, while primary school children and adolescents mostly showed atypical symptoms (p<0.001). The classical form of celiac disease occurred in 78% of the cases. Sixty (95%) patients carried HLA-DQ2.5, DQ2.2 and/or HLA-DQ8 heterodimers, and only three of them tested negative. Conclusions: Kosovo, as the majority of developing countries, is still facing the classical form of celiac disease as the dominant mode of presentation; as a result, most children with other forms of the celiac disease remain undiagnosed. : Physicians should be aware of the wide range of clinical presentations and utilize low testing thresholds in order to prevent potential long-term problems associated with untreated celiac disease.

scholarly journals Non-Celiac Gluten Sensitivity: A Challenging Diagnosis in Children with Abdominal Pain

2018 ◽  
Vol 73 (Suppl. 4) ◽  
pp. 39-46 ◽  
Author(s):  
Frank M. Ruemmele
Keyword(s):  
Abdominal Pain ◽  
Celiac Disease ◽  
Clinical Symptoms ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Clear Cut ◽  
Clinical Presentations ◽  
New Findings ◽  
Three Phase ◽  
Gi Symptoms

Several disorders related to the ingestion of gluten are well recognized despite overlapping clinical presentations: celiac disease, an autoimmune enteropathy triggered by gluten ingestions in susceptible individuals, allergy to wheat, and more recently non-celiac gluten sensitivity (NCGS). While celiac disease and wheat allergy are well-known disorders with a clear-cut diagnosis based on clinical tests and biological parameters, NCGS is a more difficult diagnosis, especially in children with functional gastrointestinal (GI) complaints. NCGS is considered a syndrome of intestinal but also extraintestinal symptoms occurring within hours, but sometimes even after several days of gluten ingestion. In children, the leading symptoms of NCGS are abdominal pain and diarrhea, while extraintestinal symptoms are rare, in contrast to adult patients. No precise diagnostic test nor specific biomarkers exist, except a rather cumbersome three-phase gluten-exposure, gluten-free diet, followed by a blinded placebo-controlled gluten challenge with crossover to provoke symptoms elicited by gluten in a reproducible manner that disappear on gluten-free alimentation. Recent data indicate that the peptide part of wheat proteins is not necessarily the sole trigger of clinical symptoms. Mono- or oligosaccharides, such as fructan and other constituents of wheat, were able to provoke GI symptoms in clinical trials. These new findings indicate that the term gluten sensitivity is probably too restrictive. The incidence of NCGS was reported in the range of 1–10% in the general population and to increase steadily; however, most data are based on patients’ self-reported gluten intolerance or avoidance without a medically confirmed diagnosis. Treatment consists of gluten avoidance for at least several weeks or months. Patients with NCGS require regular reassessment for gluten tolerance allowing with time the reintroduction of increasing amounts of gluten.

scholarly journals Gliadin Sequestration as a Novel Therapy for Celiac Disease: A Prospective Application for Polyphenols

2021 ◽  
Vol 22 (2) ◽  
pp. 595
Author(s):  
Charlene B. Van Buiten ◽  
Ryan J. Elias
Keyword(s):  
Immune Response ◽  
Celiac Disease ◽  
Gastrointestinal Symptoms ◽  
Autoimmune Disorder ◽  
Treatment Method ◽  
Mucosal Damage ◽  
Protective Effects ◽  
Novel Therapy ◽  
Gluten Proteins ◽  
Prospective Application

Celiac disease is an autoimmune disorder characterized by a heightened immune response to gluten proteins in the diet, leading to gastrointestinal symptoms and mucosal damage localized to the small intestine. Despite its prevalence, the only treatment currently available for celiac disease is complete avoidance of gluten proteins in the diet. Ongoing clinical trials have focused on targeting the immune response or gluten proteins through methods such as immunosuppression, enhanced protein degradation and protein sequestration. Recent studies suggest that polyphenols may elicit protective effects within the celiac disease milieu by disrupting the enzymatic hydrolysis of gluten proteins, sequestering gluten proteins from recognition by critical receptors in pathogenesis and exerting anti-inflammatory effects on the system as a whole. This review highlights mechanisms by which polyphenols can protect against celiac disease, takes a critical look at recent works and outlines future applications for this potential treatment method.

scholarly journals Changes in Age at Diagnosis and Nutritional Course of Celiac Disease in the Last Two Decades

Nutrients ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 156 ◽  
Author(s):  
Mónica Villanueva ◽  
Amaya Oyarzún ◽  
Bárbara Leyton ◽  
Mónica González ◽  
Elizabeth Navarro ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Nutritional Status ◽  
Gastrointestinal Symptoms ◽  
Failure To Thrive ◽  
Age At Diagnosis ◽  
Pediatric Hospitals ◽  
Geographical Variations ◽  
Number Of Patients ◽  
Antiendomysial Antibodies

The frequency of celiac disease (CD) has increased along time, with relevant changes reported in geographical variations, clinical presentation and nutritional repercussions. In recent years, some celiac patients are presenting overweight/obesity, but it is unclear how frequent this is and to what extent undernutrition remains a concern. This is relevant because CD tends to be overlooked in overweight patients. With this in mind, we assessed age at diagnosis, clinical characteristics and nutritional status of 155 celiac patients diagnosed between 1994–2017 in four pediatric hospitals in Santiago, Chile. Since 2003, the number of patients diagnosed has increased (p < 0.0033), coinciding with antitransglutaminase and antiendomysial antibodies becoming available to public health systems. In 2000, 4.5% of patients were asymptomatic at diagnosis, suggesting that active search is not routinely applied. Gastrointestinal symptoms plus failure to thrive were significantly more frequent under 2 years (p = 0.0001). Nutritional status has improved at diagnosis and during follow up, but undernutrition remains more frequent in children <2 and <5 years (p < 0.002 and p < 0.0036, respectively). Overweight at diagnosis was reported in 2002 and obesity in 2010. After initiating treatment, since 2010, patients changing from undernourishment to overweight has sometimes been observed after only 6 months on a gluten-free diet.

Hypocupraemia-induced anaemia, sensory ataxia and cognitive impairment secondary to zinc-containing dental adhesive

2021 ◽  
Vol 14 (7) ◽  
pp. e239375
Author(s):  
Rayyan Jamal ◽  
Omar Walid Dihmis ◽  
Liam Stuart Carroll ◽  
George Pengas
Keyword(s):  
Cognitive Impairment ◽  
Copper Deficiency ◽  
Dorsal Column ◽  
Blood Dyscrasia ◽  
Gait Ataxia ◽  
Copper Supplementation ◽  
Symptomatic Anaemia ◽  
Normocytic Anaemia ◽  
Zinc Levels ◽  
Excess Zinc

A 67-year-old man presented with 5 months of worsening memory impairment and sensory gait ataxia on the background of symptomatic anaemia. He experienced falls, agitation and became socially withdrawn over 3 weeks, resulting in hospital admission. On examination, he had sensory gait ataxia consistent with a dorsal column syndrome. He scored 13/30 on the Montreal Cognitive Assessment. Serum analysis showed normocytic anaemia and leucopenia, severe hypocupraemia, reduced caeruloplasmin and normal zinc levels. Overuse of zinc-containing denture cream was the cause of excess zinc ingestion and resultant copper deficiency, leading to blood dyscrasia and myelopathy. The cream was withdrawn and intravenous and then oral copper supplementation was implemented. Direct questions with regard to excess zinc in the diet and serological testing of copper and zinc should be considered in any patient with a dorsal column syndrome, particularly with concurrent anaemia. Copper deficiency may also have a role in exacerbating pre-existing cognitive impairment.

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