title: Gluten ataxia is better classified as non-celiac gluten sensitivity than as celiac disease: a comparative clinical study.
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.
authors.affiliation: Gastroenterology Unit, Central University Hospital of Asturias (HUCA), Oviedo, Spain. lrodrigosaez@gmail.com.|School of Medicine, University of Oviedo, Julian Clavería s no., 33006, Oviedo, Spain. lrodrigosaez@gmail.com.
authors.forename: Luis
authors.initials: L
authors.lastname: Rodrigo
authors.affiliation: Gastroenterology Unit, Central University Hospital of Asturias (HUCA), Oviedo, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Hernández-Lahoz
authors.affiliation: Gastroenterology Unit, Central University Hospital of Asturias (HUCA), Oviedo, Spain.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Lauret
authors.affiliation: Gastroenterology Unit, Central University Hospital of Asturias (HUCA), Oviedo, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Rodriguez-Peláez
authors.affiliation: 2nd Department of Internal Medicine, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Soucek
authors.affiliation: Clinica Medica I, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy.
authors.forename: Rachele
authors.initials: R
authors.lastname: Ciccocioppo
authors.affiliation: 2nd Department of Internal Medicine, Faculty of Medicine, Masaryk University, Brno, Czech Republic. peter.kruzliak@savba.sk.|Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Odborarov 10, 832 32, Bratislava, Slovak Republic. peter.kruzliak@savba.sk.
authors.forename: Peter
authors.initials: P
authors.lastname: Kruzliak
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000276:immunology; D001259:Ataxia / Q000178:diet therapy / Q000276:immunology* / Q000503:physiopathology*; D001921:Brain / Q000473:pathology; D002446:Celiac Disease / Q000178:diet therapy / Q000235:genetics / Q000276:immunology* / Q000503:physiopathology*; D055050:Diet, Gluten-Free; D005260:Female; D005983:Glutens / Q000276:immunology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio
chemical_list: D000906:Antibodies; D005983:Glutens
keywords: Celiac disease; Comparative study; Gluten ataxia; Non-celiac gluten sensitivity