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Mechanisms underlying celiac disease and its neurologic manifestations
Authors:P H R Green  A Alaedini  H W Sander  T H Brannagan III  N Latov  R L Chin
Institution:(1) Department of Medicine and Celiac Disease Center, College of Physicians and Surgeons, Columbia University, New York, 10022, USA;(2) Peripheral Neuropathy Center, Department of Neurology, Weill Medical College, 635 Madison Avenue, Suite 400, New York, 10022, USA
Abstract:The extra-intestinal manifestations of celiac disease (CD), including ataxia and peripheral neuropathy, are increasingly being recognized as the presenting symptoms of this autoimmune disease. Although there is a greater understanding of the pathogenesis of the intestinal lesions in CD the mechanisms behind the neurologic manifestations of CD have not been elucidated. In this article, the authors review the cellular and molecular mechanisms behind the histopathologic changes in the intestine, discuss the presentation and characteristics of neurologic manifestations of CD, review the data on the mechanisms behind these manifestations, and discuss the diagnosis and treatment of CD. Molecular mimicry and intermolecular help may play a role in the development of neurologic complications.Received 11 March 2004; received after revision 29 October 2004; accepted 12 November 2004
Keywords:Celiac disease  gluten sensitivity  ataxia  peripheral neuropathy  pathogenesis  neurologic complications  ganglioside antibodies
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