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Immunol Res. 2016 Apr;64(2):558-64. doi: 10.1007/s12026-015-8750-1.

Gluten ataxia is better classified as non-celiac gluten sensitivity than as celiac disease: a comparative clinical study.

Author information

1
Gastroenterology Unit, Central University Hospital of Asturias (HUCA), Oviedo, Spain. lrodrigosaez@gmail.com.
2
School of Medicine, University of Oviedo, Julian Clavería s no., 33006, Oviedo, Spain. lrodrigosaez@gmail.com.
3
Gastroenterology Unit, Central University Hospital of Asturias (HUCA), Oviedo, Spain.
4
2nd Department of Internal Medicine, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
5
Clinica Medica I, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy.
6
2nd Department of Internal Medicine, Faculty of Medicine, Masaryk University, Brno, Czech Republic. peter.kruzliak@savba.sk.
7
Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Odborarov 10, 832 32, Bratislava, Slovak Republic. peter.kruzliak@savba.sk.

Abstract

Gluten ataxia (GA) has customarily been considered to be the main neurological manifestation of celiac disease (CD). In recent years, the condition of non-celiac gluten sensitivity (NCGS) has been defined, which includes some patients who are not considered "true celiacs." We performed a comparative clinicopathological study of these three entities. We studied 31 GA, 48 CD and 37 NCGS patients, prospectively in the same center for a period of 7 years. The protocol study included two serological determinations for gluten sensitivity [anti-gliadin IgA and IgG (AGA) and anti-tissue transglutaminase IgA (TG) antibodies], HLA-DQ2 typing, and duodenal histological assessment. Demographics and investigative findings were compared. Females were 55 % in GA, 75 % in CD (p < 0.001), and 47 % in NCGS (N.S.). GA patients were older (59 ± 14 years) than CD (43 ± 13 years) and NCGS (41 ± 8 years) groups (p < 0.001). AGA positivity was higher in GA (100 %) than in CD (48 %) groups (p < 0.001), but similar to NCGS patients (89 %; N.S.); TG positivity was lower in GA (3.2 %) than in CD (33.3 %; p < 0.001), but similar to NCGS (2.7 %; N.S.). DQ2 (+) was lower in GA (32.2 %) than in CD (89.6 %; p < 0.001), but similar to NCGS (29.7 %; N.S.). Lymphocytic enteritis (Marsh type 1) was lower in GA (9.6 %) than in CD (66.7 %; p < 0.001), but similar to NCGS (10.8 %; N.S.). The other gluten sensitivity-related characteristics measured were different to CD patients, but very close to NCGS. We conclude that GA patients are better classified within the NCGS group, than within CD.

KEYWORDS:

Celiac disease; Comparative study; Gluten ataxia; Non-celiac gluten sensitivity

PMID:
26676361
DOI:
10.1007/s12026-015-8750-1
[Indexed for MEDLINE]

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