Celiac.com 12/28/2006 – Antonio Tursi and colleagues at the Digestive Endoscopy Unit, Lorenzo Bonomo Hospital, Andria, (BA), Italy have published a study which concludes that any neurological damage caused by celiac disease may be irreversible—even after treatment with a gluten-free diet. Although the study is relatively small, its conclusions are important—especially to those who suffer from the neurological effects of celiac disease. More research needs to be done to determine why antineuronal antibodies persist in treated celiacs. It would be interesting to see if the removal of other common offending proteins (such as casein, soy, corn, eggs, etc.) from the diets of the patients in this study would have any effect on their antineuronal antibody levels.
Below is the abstract of the study:
Dig Dis Sci. 2006 Sep 12
Peripheral Neurological Disturbances, Autonomic Dysfunction, and Antineuronal Antibodies in Adult Celiac Disease Before and After a Gluten-Free Diet.
Tursi A, Giorgetti GM, Iani C, Arciprete F, Brandimarte G, Capria A, Fontana L.
Digestive Endoscopy Unit, Lorenzo Bonomo Hospital, Andria, (BA), Italy.
Thirty-two consecutive adult celiac disease patients (pts), complaining of peripheral neuropathy (12 pts), autonomic dysfunction (17 pts), or both (3 pts), were evaluated to assess the presence of neurological damage (by clinical neurological evaluation and electrophysiological study) and antineuronal antibodies and to assess the effect of a gluten-free diet on the course of the neurological symptoms and on antineuronal antibodies. At entry, 12 of 32 (38%) pts showed signs and symptoms of neurological damage: 7 of 12 (58%), peripheral neurological damage; 3 of 12 (25%), autonomic dysfunction; and 2 (17%), both peripheral neurological damage and autonomic dysfunction. The overall TNS score was 105 at entry. Anti-GM1 antibodies were present in 5 of 12 (42%) pts: 3 showed peripheral neurological damage and 2 showed both peripheral neurological damage and autonomic dysfunction. One year after the gluten-free diet was started, histological lesions were still present in only 10 of 12 (83%) pts. TNS score was 99, 98, 98, and 101 at the 3rd, 6th, 9th, and 12th month after the gluten-free diet was started, so it did not improve throughout the follow-up. None of the pts showed disappearance of antineuronal antibodies throughout the follow-up. We conclude that adult celiac disease patients may show neurological damage and presence of antineuronal antibodies. Unfortunately, these findings do not disappear with a gluten-free diet.