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Celiac.com 02/01/2016 - Among celiac researchers, there's been a good deal of professional curiosity about the clinical and immunological relevance of anti-neuronal antibodies in celiac disease with neurological manifestations. At present, doctors don't know very much about the clinical and immunological features in celiac disease patients with neurological problems, and many of them want to know more. Researchers estimate that about 10% of celiac disease patients have neurological issues, with the majority of those suffering from anti-neuronal antibodies (NA) to central nervous system (CNS) and/or anti-neuronal antibodies to the enteric nervous system (ENS). With that in mind, the question of the importance of such antibodies in celiac patients with neurological problems becomes important. To get a better picture of the issue, a team of researchers in Italy recently set out to assess rates of anti-neuronal antibodies, and to assess their correlation with neurological disorders and bowel habits in people with celiac disease. The research team included G. Caio, R. De Giorgio, A.Venturi, F. Giancola, R. Latorre E. Boschetti, M. Serra, E. Ruggeri, and U.Volta. They are all associated with the Department of Medical and Surgical Sciences, University of Bologna and St. Orsola-Malpighi Hospital, Bologna, Italy. For their study, the team investigated anti-neuronal antibodies to central nervous system and enteric nervous system in 106 celiac disease patients and in 60 controls with autoimmune disorders, using indirect immunofluorescence on rat and/or primate cerebellar cortex and intestinal (small and large bowel) sections. Their results showed that 21% of celiac patients were positive for IgG NA to central nervous system (titer 1:50 - 1:400); nearly half of those patients showed neurological dysfunction, compared with just 8% without. (P< 0.0001). Of the 26 celiacs (24%) with IgG anti-neuronal antibodies to enteric nervous system, 11 out of 12 with an antibody titer greater than 1:200 had severe constipation. Only one patient with cerebellar ataxia and intestinal sub-occlusion was positive for anti-neuronal antibodies to central nervous system and enteric nervous system. Anti-neuronal antibodies to central nervous system and enteric nervous system were found in 7% and 5% of controls, respectively. These results confirm that the presence of anti-neuronal antibodies to central nervous system can be regarded as a marker of neurological manifestations for people with celiac disease. High titer anti-neuronal antibodies to enteric nervous system are associated with severe constipation. The presence of anti-neuronal antibodies to central nervous system and enteric nervous system is a big red flag for an immune-mediated disease path that leads to central neural impairment, and gut dysfunction with associated constipation. Source: Gastroenterol Hepatol Bed Bench. 2015 Spring;8(2):146-52.

Celiac.com 11/25/2008 - Celiac disease is one of the most under-diagnosed medical disorders, with 97% of all cases currently remaining undiagnosed. According to the National Institutes of Health, 3 million people in theUnited States with celiac disease, while only 140,000 have beendiagnosed. Celiac disease ismore than twice as common in people over 50 years of age. People with untreated celiac disease are at risk of developing anynumber of associated conditions, including gastrointestinal cancer atrates of 40 to 100 times those of the general population, in additionto osteoporosis, and a two-fold increase in the risk of fractures,including first-time hip fractures. Moreover, an unusually highpercentage of people with celiac disease suffer from the followingconditions: Anemia, Arthritis, Ataxia, Cancer—Non-Hodgkin’s Lymphoma, Cow's Milk Intolerance, Dermatitis, Diabetes-Type 1, Irritable Bowel Syndrome, Liver Disease, Migraine Headaches, Nerve Diseaseand/or Peripheral Neuropathy, Obesity, Osteoporosis,Osteomalacia/Low Bone Density, Pancreatic & Thyroid Disorders. According to a new study by doctors based in Sweden, people with celiac disease face a significantly higher risk of developing thyroid disorders, including hypothyroidism, hyperthyroidism and thyroiditis. The thyroid is a small, butterfly-shaped gland in the neck that creates the hormones that control human metabolism. People with under-active thyroid, called hypothyroidism, suffer symptoms such as fatigue, sensitivity to cold, dry skin and weight gain, while people with overactive thyroid, called hyperthyroidism, commonly suffer from symptoms such as excessive sweating, heat intolerance, and nervousness. However, mild cases of hypo- or hyperthyroidism commonly present no symptoms at all. Inflammation of the thyroid gland is called Thyroiditis. The research team, led by Dr. Peter Elfstrom at Orebro University Hospital, reviewed Swedish national health records covering the period from 1963 to 2003. The team compared rates of thyroid disease for 14,000 people with celiac disease against some 68,000 non-celiac control subjects matched for age and gender. The results showed that people with celiac disease are diagnosed with hypothyroidism more than four times as often as non-celiacs, with hyperthyroidism more than three times as often as non-celiacs, and with hyperthyroidism more than 3.6 times as often as non-celiacs. Moreover, the relationship works both ways: people with established hypothyroidism, hyperthyroidism and thyroiditis face much higher rates of celiac disease. These results held true even after the data were adjusted for potential confounders, including the presence of diabetes mellitus. The researchers theorize that the association between celiac disease and thyroid disease may be due to shared genetic or immunological traits. This is just the latest in a string of studies that drives home the importance of early testing for suspected celiac cases, as early discovery and treatment with a gluten free diet greatly reduces associated complications in celiac disease. Journal of Clinical Endocrinology and Metabolism, October 2008.