title: Celiac disease with cerebral and peripheral nerve involvement mimicking multiple sclerosis.
abstract: OBJECTIVE
  Due to the similarity in the clinical presentation, morphology, and course, celiac disease (CD) may be mixed up with other immunological disorders, such as multiple sclerosis (MS).
  
  
  METHODS
  In a 43-year-old Caucasian male with a history of diarrhea and colics since young age, progressive sensory disturbances developed since age 18 years. At age 34, he was diagnosed as relapsing-remitting MS upon an inflammatory CSF-syndrome and non-specific white matter lesions and treated with interferon beta-1b during the next 8 years without effect. At age 35, axonal polyneuropathy and ataxia were diagnosed. Despite normal anti-gliadin, endomysial, and transglutaminase antibodies, CD was diagnosed at age 41, based upon the history, polyneuropathy, positivity for HLA-DQ2 and HLA-DQ8, the white matter lesions, and a beneficial response of the gastrointestinal problems and polyneuropathy to gluten-free diet.
  
  
  CONCLUSIONS
  CD may mimic MS and may be present despite the absence of anti-gliadin, endomysial or transglutaminase antibodies. CD should be considered if there is a gastrointestinal problem, polyneuropathy, and ataxia, even if CSF and MRI findings are suggestive of MS.
authors.affiliation: Krankenanstalt Rudolfstiftung, Vienna, Austria.
authors.forename: J
authors.initials: J
authors.lastname: Finsterer
authors.affiliation: Department of Neurology, Medical University Vienna, Austria.
authors.forename: F
authors.initials: F
authors.lastname: Leutmezer
mesh_terms: D000328:Adult; D002446:Celiac Disease / Q000175:diagnosis* / Q000178:diet therapy / Q000473:pathology*; D054022:Cerebrum / Q000473:pathology*; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009103:Multiple Sclerosis / Q000175:diagnosis*; D009431:Neural Conduction / Q000502:physiology; D010525:Peripheral Nerves / Q000473:pathology*
keywords: autoantibodies; immunology; immunosuppression; interferon; nerve conduction