Clinical findings and anti-neuronal antibodies in coeliac disease with neurological disorders

Scand J Gastroenterol. 2002 Nov;37(11):1276-81. doi: 10.1080/003655202761020542.


Background: Little is known about the clinical and immunological features of coeliac disease patients with neurological disorders. In a large series of adult coeliac disease patients, we investigated the prevalence of neurological disorders and anti-neuronal antibodies, along with the clinical course.

Methods: Neurological symptoms were investigated in 160 consecutive patients (120 F, 40 M) with biopsy-proven coeliac disease. Anti-neuronal antibodies to central/enteric nervous systems were investigated in all neurological patients, 20 unaffected ones and 20 controls.

Results: Thirteen (8%) patients had neurological disorders, including epilepsy (n = 3), attention/memory impairment (n = 3), cerebellar ataxia (n = 2), peripheral neuropathy (n = 2), multiple sclerosis (n = 1), Moyamoya disease (n = 1) and Steinert's disease (n = 1). No significant demographic or clinical differences (gastrointestinal or other gluten-related signs) were found between patients with and without neurological involvement. In all but 2 of the 13 cases, the neurological disorder preceded diagnosis ofcoeliac disease. Neurological symptoms improved or disappeared in 7 patients who started a gluten-free diet within 6 months after neurological onset, and in none of 4 patients who began later. Prevalence of central nervous system anti-neuronal antibodies was significantly higher in neurological (61%) than in other patients (5%) (P = 0.0007) or controls (0%) (P = 0.00001).

Conclusions: Coeliac disease can sometimes present in the guise of a neurological disorder, which may greatly improve when a gluten-free diet is started promptly. Therefore, the possible presence of coeliac disease needs to be carefully considered in patients with cerebellar ataxia, epilepsy, attention/memory impairment or peripheral neuropathy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies, Anti-Idiotypic / blood
  • Antibodies, Anti-Idiotypic / immunology*
  • Celiac Disease / complications*
  • Celiac Disease / diet therapy
  • Celiac Disease / immunology*
  • Diet Therapy / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nervous System Diseases / complications*
  • Nervous System Diseases / epidemiology
  • Nervous System Diseases / immunology*
  • Neurons / immunology*
  • Prevalence


  • Antibodies, Anti-Idiotypic