Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan;268(1):199-205.
doi: 10.1007/s00415-020-10137-6. Epub 2020 Aug 4.

Gluten neuropathy: electrophysiological progression and HLA associations

Panagiotis Zis  1   2   3 , Ptolemaios Sarrigiannis  4 , Artemios Artemiadis  5 , David S Sanders  6 , Marios Hadjivassiliou  4
Affiliations

Gluten neuropathy: electrophysiological progression and HLA associations

Panagiotis Zis et al. J Neurol. 2021 Jan.

Abstract

Objective: Gluten neuropathy (GN) is the term used to describe peripheral neuropathy that occurs in patients with gluten sensitivity (GS) or coeliac disease (CD) in the absence of other risk factors. We aimed to describe the neurophysiological progression rate of GN across time and look into the potential role of genetic susceptibility in its development.

Methods: This is a cohort study of 45 patients with GN with a mean follow-up period of 8 ± 5 years. The assessments included clinical and neurophysiological data and HLA-DQ genotyping.

Results: The mean age at diagnosis was 60 ± 12 years. The majority of patients had a length-dependent neuropathy (75.6%), whereas the rest were diagnosed with sensory ganglionopathy (SG). DQA1*02-positive patients were more likely to suffer with SG compared to the DQA1*02 negative patients (60% versus 13.8%, p = 0.009). There was also a trend for statistical significance regarding the DQB1*06 allele and the DQA1*01/DQB1*06 haplotype were found more frequently in patients with GN than in healthy controls (p = 0.026 and p = 0.047, respectively). A linear effect of time on the neurophysiological findings was found in radial sensory nerve action potential (1.9% mean annual decrement, p = 0.036), sural sensory nerve action potential (3.3% mean annual decrement, p = 0.013) and tibial nerve motor compound action potential (6.5% mean annual decrement, p < 0.001) amplitudes, independently from age or gender.

Conclusions: GN is a late manifestation of GS and CD. The majority of patients have the length-dependent neuropathy with a linear deterioration over time. HLA genotyping of GS and CD patients who suffer from neuropathic symptoms is recommended as it can help identifying patients at risk for developing SG.

Keywords: Coeliac disease; Gluten sensitivity; HLA genotyping; Peripheral neuropathy; Progression.

PubMed Disclaimer

References

    1. Brown WC (1908) Sprue and its treatment. Bale and Danielsson
    1. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A (1996) Does cryptic gluten sensitivity play a part in neurological illness? Lancet 347(8998):369–371 - DOI
    1. Hadjivassiliou M, Sanders DS, Grünewald RA, Woodroofe N, Boscolo S, Aeschlimann D (2010) Gluten sensitivity: from gut to brain. Lancet Neurol 9(3):318–330 - DOI
    1. Zis P, Sarrigiannis PG, Rao DG, Hadjivassiliou M (2018) Quality of life in patients with gluten neuropathy: a case-controlled study. Nutrients 10(6)
    1. Hadjivassiliou M, Croall ID, Zis P, Sarrigiannis PG, Sanders DS, Aeschlimann P, Grünewald RA, Armitage PA, Connolly D, Aeschlimann D, Hoggard N (2019) Neurologic deficits in patients with newly diagnosed celiac disease are frequent and linked with autoimmunity to transglutaminase 6. Clin Gastroenterol Hepatol 17(13):2678–2686 - DOI

LinkOut - more resources