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Brain White-Matter Lesions are Common in Celiac Disease

PEDIATRICS Vol. 108 No. 2 August 2001, p. e21
Kieslich M, Errazuriz G, Posselt HG, Moeller-Hartmann W, Zanella F, Boehles H.
Departments of Pediatrics, Johann Wolfgang Goethe University, Frankfurt/Main, Germany.

Celiac.com 08/24/2001 - It is well known that celiac disease causes destruction of the villi in the small intestine that results in malabsorption of nutrients in affected individuals. There is solid evidence that additional neurological complications can result, such as epilepsy, possibly associated with occipital calcifications or folate deficiency and cerebellar ataxia. An increase in brain white-matter lesions has been reported in patients with Crohn disease and ulcerative colitis, but until now, not in patients with celiac disease. A recent study published in the August 2, 2001 issue of Pediatrics has now demonstrated a similar increase of these lesions in patients with celiac disease.

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The study was carried out by Dr. Kieslich and colleagues of the Departments of Pediatrics, Johann Wolfgang Goethe University, Frankfurt/Main, Germany, on 75 biopsy-proven celiac disease patients who were on a gluten-free diet. Most of the patients in the study were between 2.8 and 24.2 years old, and the mean age was 11.6 years. All of the patients underwent prospectively clinical neurological examinations, laboratory investigations, electroencephalography, computed tomography, and magnetic resonance imaging. According to the study the mean period of gluten exposure was 2.4 years, although it was likely longer as recent studies have shown that many celiacs are asymptomatic for many years before damage occurs that is severe enough to cause obvious symptoms.

The researchers found that ten of the patients had neurological manifestations such as febrile seizures, single generalized seizures, mild ataxia, and muscular hypotonia with retarded motor development, although no folate deficiencies were found. Further, the hippocampal regions appeared normal, and no cerebral calcifications were found, however, the MRI results showed unilateral and bilateral T2-hyperintensive white-matter lesions in 15 patients (20%). According to the research, there does not appear to be a relationship between these lesions and dietary compliance or neurological or electroencephalographic abnormalities.

The researchers conclude that focal white-matter lesions in the brain may represent an extra-intestinal manifestation of celiac disease. They theorize that the lesions may be the result of a decreased blood supply caused by the constriction or obstruction of blood vessels due to inflammation, or caused by the destruction of the nerve fiber due to inflammation. Further, children with white-matter lesions, even if they do not have intestinal symptoms, should be tested for celiac disease. Last, more research needs to be done on people celiac disease of all ages to develop a proper predictive value, and to discover the exact cause of the lesions.

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5 Responses:

 
C. Bonnie Hamre
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said this on
21 Mar 2010 12:07:08 PM PDT
Plenty of valuable information.

 
Terri Cunningham
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said this on
04 Apr 2011 11:45:40 PM PDT
I am a 58 year old woman with recently diagnosed celiac disease. I was diagnosed in 2000 with MS. My father had Crohn's and Parkinson's disease. As well, my 11 year old niece developed seizures as a result of epilepsy. I am now wondering whether she should also be tested for celiac. Thank you for this information.

 
Kit Kellison
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said this on
20 Apr 2011 8:41:09 PM PDT
Hi Terri,

You are right to be concerned.

2nd degree relatives like your niece have an increased prevalence of celiac disease. With a manifestation like epilepsy, she should be tested for celiac disease.

 
monica

said this on
11 Jul 2011 1:15:37 PM PDT
Just found I had celiac two weeks ago. The white brain matter was due to my passed drug abuse and that spasms and seizure were psychogenic and so and so forth for the last 10 years. I became so malnourished I almost died and was told I had anorexia. My psychiatrist told me to check out celiac and see a doctor fast. If hadn't of changed my diet before I saw the doctor I might not be here today.

 
Krystal
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said this on
29 Aug 2012 11:19:08 PM PDT
I was experiencing alarming neurological symptoms (amongst other things), and upon having an MRI discovered large white matter lesions inconsistent with MS, and also rare in someone my age (30). They had no explanation for them. Out of desperation I sought natural therapies, and after an examination on the advice of my naturopath I attempted a gluten-free diet. It was like a new me! I experienced the best sleep of my life, no migraines, better concentration skills and complete alleviation of my heartburn/cramps etc. I told my doctor about it, she arranged for me to be tested - and celiac disease was the diagnosis. I wish I'd been diagnosed a decade ago and a lot of suffering could have been avoided!




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Gaerty, thank you for sharing this with me! You want to know something crazy? The night before you sent this I was googling "vitamin deficiencies linked to splinter hemorrhages" and an article came up about vitamin C deficiency. I can't remember the last time I took vitamin C or drank orange juice or consumed anything that has vitamin C on a regular basis. It's crazy that you responded to this post when you did. My splinter hemorrhage is razor thin and looks like it could be shrinking but it's hard to tell. Also it's not growing out of the nail bed. It stated more in the middle of my right thumb nail. I don't take a multivitamin mainly because I can't find one that doesn't trigger my anxiety. Trying to find a good one that doesn't have energy boosters in it like green tea and extra B vitamins (all my B vitamin levels are great). I haven't been tested for low C vitamin levels but I might have to now. I was tested for some of the base ones that most celiacs have issues with, folate, magnesium, B's, E's, and a couple others and all of them came back good with the exception of my vitamin D3 which in November 2016 was 16 and we tested it again in February, it moved up to 26. Still low but moving up. My liver numbers in October 2016 were bad but by February 2017 they were perfect. I had skin rashes, most of those have cleared up over the past 5 to 6 months, by about 85%, since I was diagnosed. This splinter hemorrhage came up about 7 to 8 weeks ago. Like I said it appears to be growing out but I'm still going to get it looked at. Let me know what your doc says about the vitamin C levels. Also what multivitamin do you take? Ps: I bought some clementines yesterday. Thanks for responding! Spencer

Maybe try a rice based milk, I find the coconut flavoured ones really good with cereal.

I guess they've never felt the political pressure the mainstream cereal producers were under in the age of rickets and pellagra? Plus there's not such a competitive market and its a cost manufacturers would sooner do without if they can, although if Udi's or Genius did start perhaps they'd get more business. I think I'll start eating flax seed again, that was good for fibre I think. I take a vitamin supplement also of course.

Good for you! One suggestion, if you run into another reaction like your Endo, try and ask a question which puts the burden of proof on them, ie: 'Given the positive blood test, on what clinical basis are you excluding celiac?' At least it forces them to be more precise and perhaps exposes any flaws in their reasoning. Although if you reach that stage with a doctor it's probably worth looking for another... If I were a cynic I'd say your Endo had already metaphorically left the building when they were analysing your tests.Your primary seems more on the ball though Best of luck! If and when you go gluten free come back here and there will be plenty of support for you.

Great Image JMG. Thanks for the feedback. I think I feel that the decision to push for further tests, and not shrug it off is the direction I want to go. And I think I may try the diet post-endoscopy, and see if I respond (particularly if my thyroid responds to the diet). Thank you All!