Neuromuscular disorder as a presenting feature of coeliac disease

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 63; no. 6; pp. 770 - 775
• Main Authors: Hadjivassiliou, M, Chattopadhyay, A K, Davies-Jones, G A B, Gibson, A, Grünewald, R A, Lobo, A J
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.12.1997; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adolescent; Adult; Aged; Ankle; Antibodies - immunology; Ataxia; Biological and medical sciences; Biopsy; Celiac disease; Celiac Disease - complications; Celiac Disease - diagnosis; coeliac disease; Electromyography; Epilepsy; Female; Gastroenterology. Liver. Pancreas. Abdomen; Gliadin - immunology; gluten sensitivity; Humans; Male; Median Nerve - pathology; Medical sciences; Middle Aged; Muscle, Skeletal - pathology; Neural Conduction; Neuromuscular Diseases - diagnosis; Neuromuscular Diseases - etiology; neuromuscular disorders; Other diseases. Semiology; Patients; Peripheral neuropathy; Peroneal Nerve - pathology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Sural Nerve - pathology; Human; Immunopathology; Symptomatology; Nervous system diseases; Intestinal malabsorption; Digestive diseases; Intestinal disease; Coeliac disease
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.63.6.770

OBJECTIVES To describe the range of neuromuscular disorders which may be associated with cryptic coeliac disease. METHODS Nine patients were described with neuromuscular disorders associated with circulating antigliadin antibodies, whose duodenal biopsies later confirmed the diagnosis of coeliac disease. Neurological symptoms antedated the diagnosis of coeliac disease in all, and most had minimal or no gastrointestinal symptoms at the onset of the neuromuscular disorder. RESULTS Three patients had sensorimotor axonal peripheral neuropathy, one had axonal motor peripheral neuropathy, one had probable inclusion body myositis and axonal motor peripheral neuropathy, one had polymyositis and sensorimotor peripheral neuropathy, one had mononeuropathy multiplex, one had neuromyotonia, and one had polyneuropathy. CONCLUSION A wide range of neuromuscular disease may be the presenting feature of coeliac disease. This represents the first report of inclusion body myositis and neuromyotonia associated with coeliac disease. Estimation of circulating antigliadin antibodies should be considered in all patients with neuromuscular disease of otherwise obscure aetiology.