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Celiac Neuropathy Guide

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Sat, 31 May 2008 17:55:07
By CIDPUSA, MD.,

Celiac Polyneuropathy updated 4/18/ 2020

Return to Neurological Variants of celiac disease

Peripheral neuropathy (PN) is one of the most frequently reported neurologic manifestations in celiac disease (CD), a autoimmune disorder that results from a loss of tolerance to gluten.

Sensory axonal and small fiber sensory polyneuropathies are the most frequently reported PN subtypes. Multifocal motor or sensorimotor neuropathies and a more fulminant neuropathy, associated with ataxia and other neurologic manifestations. The effect of a gluten-free diet on CD-associated PN has not been studied; nevertheless, a gluten-free diet currently is the cornerstone of therapy.

Ataxia associated with anti-gliadin antibodies and other neurologic complications have been reported to respond to this diet; there is data that indicate that neurologic manifestations may develop or persist, independent of gluten exposure.

There is evidence to suggest that autoimmune inflammatory processes may be involved. Immunomodulatory agents (such as intravenous immunoglobulin or infliximab), described to be beneficial in the treatment of refractory CD or CD-associated ataxia, may have a role in the management of CD-associated PN.

Many patients will benefit from Vitamin-D, Vitamin B-12, B-6 , B-1 and Niacin in their diet. Please see the vitamin Section of the website.

Celiac disease, or gluten sensitivity, is an autoimmune inflammatory disease that damages the villi - the small, finger-like projections that line the small intestine. For people with celiac disease, eating foods containing gluten - a protein found in wheat and other grains - sets off an autoimmune reaction that causes the villi to shorten and eventually flatten. Without healthy villi, a person becomes malnourished, regardless of the quantity of food eaten. Left untreated, celiac disease can lead to serious long-term conditions such as cancer, osteoporosis, anemia and seizures, and may become life threatening.

Celiac disease is linked to a genetic pre-disposition for the disease. Individuals may show no signs of celiac disease until later in life, when symptoms appear, apparently triggered by surgery, viral infection, pregnancy, childbirth, or a stressful event. Infants and children with celiac disease may fail to grow and develop properly.

A recent study found that some people with celiac disease had neuropathic symptoms before the gastrointestinal symptoms of celiac disease appeared. The results of this study, and the fact that 10 percent of people with celiac disease suffer from an associated neurological condition (usually peripheral neuropathy or ataxia - a condition characterized by jerky, uncoordinated movements and gait), indicates that patients with neuropathy of an unknown cause should be tested for celiac disease.

Because celiac disease is common in Europe, it is now thought that the disorder has been significantly under-diagnosed in the United States. A study published in the February 10, 2003 Archives of Internal Medicine suggests that one in 133 Americans are at risk for celiac disease (up from earlier estimates of one in 250), yet only one in 4,700 Americans have been diagnosed with it

SYMPTOMS Celiac disease

(Not all symptoms and signs may be present.)
Celiac disease affects people differently. Symptoms may or may not show up in the digestive system, and some people who are affected with the disease may not appear to have symptoms.
Anemia
Change in weight
Chronic diarrhea or constipation (or both)
Failure to thrive in infants or delayed growth
General weakness
Neuropathic symptoms
Burning, tingling and numbness in hands and feet
Loss of feeling in the hands and feet
Numbness, tingling or reduced sensation in the face and body
Oily, foul-smelling stools
Stomach problems, cramping, gas, distention, bloating, vomiting

Treatment:

Celiac neuropathy reponds to a gluten free diet and if quick reponce is needed a course of IVIG helps.
Continue to gluten free diet.