Celiac neuropathy
Celiac neuropathy
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DOI：
10.1212/01.wnl.0000063307.84039.c7
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发表时间：
2003-05-27
期刊：
影响因子：
9.9
通讯作者：
Latov, N
中科院分区：
文献类型：
--
作者：
Chin, RL;Sander, HW;Latov, N
背景：乳糜泻(CD)。是一种慢性炎症性肠病，是由于对摄入的面筋过敏引起的。据估计，10%的受影响患者会出现神经系统并发症，其中共济失调和周围神经病变是最常见的问题。镉相关性周围神经病患者的发病率和临床表现以前没有被调查过。目的：了解CD在神经病患者中的发生率及临床表现特点。方法：回顾分析20例经病理证实的神经病患者的临床资料。结果：20例患者中有6例仅有神经性症状，未累及胃肠道，3例先于其他CD症状。所有患者都有手脚灼热、刺痛和麻木，并有远端感觉丧失，9例患者有累及面部、躯干或腰骶区的弥漫性感觉异常。只有两个人有弱点。电生理检查结果正常或轻度异常18例(90%)。取自三名患者的腓肠神经活检显示为轻度至重度轴索病变。采用凝集试验，13例(65%)患者神经节苷脂抗体阳性。排除被诊断为腹腔神经病的患者，CD在所有神经病患者中约占2.5%，在我们中心看到的神经病变和正常电生理检查的患者中占8%。结论：CD通常与感觉神经病有关，即使在没有胃肠道症状的情况下也应考虑CD。
Background: Celiac disease (CD). is a chronic inflammatory enteropathy resulting from sensitivity to ingested gluten. Neurologic complications are estimated to occur in 10% of affected patients, with ataxia and peripheral neuropathy being the most common problems. The incidence and clinical presentation of patients with CD-associated peripheral neuropathy have not previously been investigated. Objective: To determine the incidence of CD in patients with neuropathy and to characterize the clinical presentation. Methods: The records of 20 patients with neuropathy and biopsyconfirmed CD were reviewed. Results: Six of the 20 patients had neuropathic symptoms alone without gastrointestinal involvement, and neuropathic symptoms preceded other CD symptoms in another 3 patients. All patients had burning, tingling, and numbness in their hands and feet, with distal sensory loss, and nine had diffuse paresthesias involving the face, trunk, or lumbosacral region. Only two had weakness. Results of electrophysiologic studies were normal or mildly abnormal in 18 (90%) of the patients. Sural nerve biopsies, obtained from three patients, revealed mild to severe axonopathy. Using the agglutination assay, 13 (65%) of the patients were positive for ganglioside antibodies. Excluding patients who were referred with the diagnosis of celiac neuropathy, CD was seen in approximately 2.5% of all neuropathy patients and in 8% of patients with neuropathy and normal electrophysiologic studies seen at our center. Conclusion: CD is commonly associated with sensory neuropathy and should be considered even in the absence of gastrointestinal symptoms.