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#19
09.07.2013, 00:11
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Информация к размышлению для Вас и Вашего врача:
J Neurol Neurosurg Psychiatry. 2006 Nov;77(11):1262-6. Epub 2006 Jul 11. Neuropathy associated with gluten sensitivity. Hadjivassiliou M, Grünewald RA, Kandler RH, Chattopadhyay AK, Jarratt JA, Sanders DS, Sharrack B, Wharton SB, Davies-Jones GA. Department of Neurology, The Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK. OBJECTIVES: To prospectively study the clinical, neurophysiological and neuropathological characteristics of axonal neuropathies associated with positive antigliadin antibodies and the prevalence of such neuropathies in a cohort of patients with sporadic axonal neuropathy. METHODS: Prospective screening (using antigliadin, antiendomysium and tissue transglutaminase antibodies) of patients with peripheral neuropathy attending a neurology clinic. RESULTS: 215 patients with axonal neuropathy were screened. 141 patients had symmetrical sensorimotor neuropathy, 47 had mononeuropathy multiplex, 17 had motor neuropathy and 10 had small-fibre neuropathy. Despite extensive investigations of the 215 patients, 140 had idiopathic neuropathy. Positive immunoglobulin (Ig)G with or without IgA antigliadin antibodies was found in 34% (47/140) of the patients with idiopathic neuropathy. This compares with 12% prevalence of these antibodies in the healthy controls. The prevalence of coeliac disease as shown by biopsy in the idiopathic group was at least 9% as compared with 1% in the controls. The clinical features of 100 patients (47 from the prevalence study and 53 referred from elsewhere) with gluten neuropathy included a mean age at onset of 55 (range 24-77) years and a mean duration of neuropathy of 9 (range 1-33) years. Gluten-sensitive enteropathy was present in 29% of patients. The human leucocyte antigen types associated with coeliac disease were found in 80% of patients. CONCLUSIONS: Gluten sensitivity may be aetiologically linked to a substantial number of idiopathic axonal neuropathies. --- Neurology. 2006 Jun 27;66(12):1923-5. Multifocal axonal polyneuropathy in celiac disease. Chin RL, Tseng VG, Green PH, Sander HW, Brannagan TH 3rd, Latov N. Peripheral Neuropathy Center, Department of Neurology and Neuroscience, Weill Medical College of Cornell University, New York, NY 10022, USA. The authors report six patients with multifocal axonal polyneuropathy and the subsequent diagnosis of celiac disease (CD). Five patients did not improve or had only modest improvement following dietary intervention or immune therapies; one patient with marked weakness and mild electrodiagnostic findings had complete resolution of the neuropathy following immunomodulatory therapy. CD may be a cause of multifocal axonal polyneuropathy. 
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#20
10.07.2013, 21:32
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Спасибо большое, уважаемый Вадим Валерьевич! Очень интересная информация, всегда считала что целиакия дебютирует в раннем детстве. Подскажите пожалуйста, кроме анализов для исключения целиакии, есть необходимость в исследовании на гомоцистеин о котором тоже здесь прозвучало ? Что то еще посмотреть ?
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#21
10.07.2013, 23:23
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Классическую форму целиакии легко распознать и установить диагноз с детства, атипичные формы более распространены, но диагностируются как "целиакия" позже, вот типичный пример (описание 6 случаев в возрасте 17-76 лет), когда неврологическая симптоматика предшествовала диагнозу целиакия:
J Neurol Neurosurg Psychiatry. 1997 Dec;63(6):770-5. Neuromuscular disorder as a presenting feature of coeliac disease. [Ссылки доступны только зарегистрированным пользователям ] гомоцистеин для исключения латентного дефицита В9-В12 мог быть полезен
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Линейный вид
