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. 2019 Feb 12;11(2):380.
doi: 10.3390/nu11020380.

Neurological Manifestations of Neuropathy and Ataxia in Celiac Disease: A Systematic Review

Elizabeth S Mearns  1 , Aliki Taylor  2 , Kelly J Thomas Craig  3 , Stefanie Puglielli  4 , Daniel A Leffler  5 , David S Sanders  6 , Benjamin Lebwohl  7 , Marios Hadjivassiliou  8
Affiliations

Neurological Manifestations of Neuropathy and Ataxia in Celiac Disease: A Systematic Review

Elizabeth S Mearns et al. Nutrients. .

Abstract

Celiac disease (CD) is an immune-mediated gastrointestinal disorder driven by innate and adaptive immune responses to gluten. Patients with CD are at an increased risk of several neurological manifestations, frequently peripheral neuropathy and gluten ataxia. A systematic literature review of the most commonly reported neurological manifestations (neuropathy and ataxia) associated with CD was performed. MEDLINE, Embase, the Cochrane Library, and conference proceedings were systematically searched from January 2007 through September 2018. Included studies evaluated patients with CD with at least one neurological manifestation of interest and reported prevalence, and/or incidence, and/or clinical outcomes. Sixteen studies were included describing the risk of gluten neuropathy and/or gluten ataxia in patients with CD. Gluten neuropathy was a neurological manifestation in CD (up to 39%) in 13 studies. Nine studies reported a lower risk and/or prevalence of gluten ataxia with a range of 0%⁻6%. Adherence to a gluten-free diet appeared to improve symptoms of both neuropathy and ataxia. The prevalence of gluten neuropathy and gluten ataxia in patients with CD varied in reported studies, but the increased risk supports the need for physicians to consider CD in patients with ataxia and neurological manifestations of unknown etiology.

Keywords: celiac disease; gluten ataxia; gluten neuropathy; gluten-free diet; incidence; prevalence.

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Conflict of interest statement

E.M., A.C., S.P., and K.C. were employees of IBM Watson Health during the completion of this study. A.T., M.G., and D.L. were employees of Takeda Pharmaceuticals International Co during the completion of this study. D.S., B.L., and M.H. serve as consultants for Takeda Pharmaceuticals International Co. The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow Diagram Showing the Results of the Literature Search.
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References

    1. Rubio-Tapia A., Hill I.D., Kelly C.P., Calderwood A.H., Murray J.A. ACG clinical guidelines: Diagnosis and management of celiac disease. Am. J. Gastroenterol. 2013;108:656–676. doi: 10.1038/ajg.2013.79. - DOI - PMC - PubMed
    1. Tonutti E., Bizzaro N. Diagnosis and classification of celiac disease and gluten sensitivity. Autoimmun. Rev. 2014;13:472–476. doi: 10.1016/j.autrev.2014.01.043. - DOI - PubMed
    1. Ludvigsson J.F., Leffler D.A., Bai J.C., Biagi F., Fasano A., Green P.H., Hadjivassiliou M., Kaukinen K., Kelly C.P., Leonard J.N., et al. The Oslo definitions for coeliac disease and related terms. Gut. 2013;62:43–52. doi: 10.1136/gutjnl-2011-301346. - DOI - PMC - PubMed
    1. Green P.H., Lebwohl B., Greywoode R. Celiac disease. J. Allergy Clin. Immunol. 2015;135:1099–1106. doi: 10.1016/j.jaci.2015.01.044. - DOI - PubMed
    1. Reilly N.R., Green P.H. Epidemiology and clinical presentations of celiac disease. Semin. Immunopathol. 2012;34:473–478. doi: 10.1007/s00281-012-0311-2. - DOI - PubMed

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