Celiac Neuropathy Should be Considered when Neuropathy has Unknown Origin

Celiac.com 11/27/2002 - According to recommendations made at the 127th Annual Scientific Meeting of the American Neurological Association (ANA), a diagnosis of celiac neuropathy should be considered in patients with neuropathy of otherwise unknown etiology, including in patients without any gastrointestinal symptoms. Dr. Russell L. Chin and colleagues from the Columbia University College of Physicians and Surgeons in New York, New York reviewed the records of 20 patients who had neuropathy and biopsy-confirmed celiac disease and found that six had neuropathic symptoms with no gastrointestinal symptoms and three had the neuropathic symptoms before any symptoms of celiac disease appeared. All of the patients had burning, tingling and numbness in their hands and feet that included distal sensory loss, and nine had diffuse paresthesias that involved the face, trunk, and/or lumbosacral region. Two of these patients also exhibited weakness.

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Electromyography (nerve conduction) studies were normal or slightly abnormal in 18 of the patients and sural nerve biopsies that were examined in three of the patients revealed moderate to severe axonopathies. Thirteen of the patients tested positive for ganglioside antibodies using the agglutination assay, and celiac disease was seen in five percent of all neuropathy patients, and in 20 percent of patients who were seen at the institution for neuropathy with normal electrophysiological studies.

Based on these results and the fact that 10 percent of patients with celiac disease exhibit associated neurological disease, usually in the form of peripheral neuropathy or ataxia, Dr. Chin recommends that all patients with neuropathy of unknown origin should be screened for celiac disease, even if they have no gastrointestinal symptoms.