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. 2022 May;43(5):3381-3385.
doi: 10.1007/s10072-021-05751-9. Epub 2021 Nov 17.

Sudomotor dysfunction in patients with gluten neuropathy

Panagiotis Zis  1   2 , Faiza Shafique  3 , Ptolemaios G Sarrigiannis  4 , Artemios Artemiadis  5 , Dasappaiah G Rao  3 , David S Sanders  6   3 , Marios Hadjivassiliou  6   3
Affiliations

Sudomotor dysfunction in patients with gluten neuropathy

Panagiotis Zis et al. Neurol Sci. 2022 May.

Abstract

Background and aim: Gluten neuropathy (GN) is a common neurological manifestation of gluten sensitivity (GS), characterized by serological evidence of GS, while other risk factors for developing neuropathy are absent. The degree of small fiber dysfunction in GN has not been studied in depth to date. Small fiber involvement may lead to pain, thermal perception abnormalities, and sweat gland dysfunction. Sudomotor innervation refers to the cholinergic innervation of the sympathetic nervous system through small fibers in the sweat glands. The aim of our study was to assess the sudomotor function of GN patients.

Methods: Patients with GN were recruited. Clinical and neurophysiological data were obtained. HLA-DQ genotyping was performed. The skin electrochemical conductance (ESC) was measured with SUDOSCANTM.

Results: Thirty-two patients (25 males, mean age 69.5±10.2 years) were recruited. Thirteen patients (40.6%) had abnormal sudomotor function of the hands. Sixteen patients (50%) had abnormal sudomotor function of the feet. Twenty-one patients (65.6%) had abnormal sudomotor function of either the hands or feet. Sudomotor dysfunction did not correlate with the type of neuropathy (length-dependent neuropathy or sensory ganglionopathy), gluten-free diet adherence, severity of neuropathy, and duration of disease or HLA-DQ genotype. No differences in the ESC were found between patients with painful and patients with painless GN.

Conclusion: Sudomotor dysfunction affects two-thirds of patients with GN. The lack of correlation between pain and sudomotor dysfunction suggests different patterns of small fiber involvement in patients with GN.

Keywords: Autonomic; Gluten neuropathy; SUDOSCAN; Small fiber; Sudomotor.

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References

    1. Hadjivassiliou M, Sanders DS, Grünewald RA, Woodroofe N, Boscolo S, Aeschlimann D. Gluten sensitivity: from gut to brain. Lancet Neurol. 2010;9(3):318–330. doi: 10.1016/S1474-4422(09)70290-X. - DOI - PubMed
    1. Zis P, Sarrigiannis PG, Rao DG, Hewamadduma C, Hadjivassiliou M. Chronic idiopathic axonal polyneuropathy: a systematic review. J Neurol. 2016;263(10):1903–1910. doi: 10.1007/s00415-016-8082-7. - DOI - PubMed
    1. Zis P, Rao DG, Sarrigiannis PG, Aeschlimann P, Aeschlimann DP, Sanders D, Grünewald RA, Hadjivassiliou M. Transglutaminase 6 antibodies in gluten neuropathy. Dig Liver Dis. 2017;49(11):1196–1200. doi: 10.1016/j.dld.2017.08.019. - DOI - PubMed
    1. Hadjivassiliou M, Rao DG, Wharton SB, Sanders DS, Grünewald RA, Davies-Jones AG. Sensory ganglionopathy due to gluten sensitivity. Neurology. 2010;75(11):1003–1008. doi: 10.1212/WNL.0b013e3181f25ee0. - DOI - PubMed
    1. Zis P, Sarrigiannis P, Artemiadis A, Sanders DS, Hadjivassiliou M. Gluten neuropathy: electrophysiological progression and HLA associations. J Neurol. 2021;268(1):199–205. doi: 10.1007/s00415-020-10137-6. - DOI - PubMed