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The Significance of Low Titre Antigliadin Antibodies in the Diagnosis of Gluten Ataxia.
- Source :
-
Nutrients [Nutrients] 2018 Oct 05; Vol. 10 (10). Date of Electronic Publication: 2018 Oct 05. - Publication Year :
- 2018
-
Abstract
- Background: Patients with gluten ataxia (GA) without enteropathy have lower levels of antigliadin antibodies (AGA) compared to patients with coeliac disease (CD). Magnetic Resonance Spectroscopy (NAA/Cr area ratio) of the cerebellum improves in patients with GA following a strict gluten-free diet (GFD). This is associated with clinical improvement. We present our experience of the effect of a GFD in patients with ataxia and low levels of AGA antibodies measured by a commercial assay.<br />Methods: Consecutive patients with ataxia and serum AGA levels below the positive cut-off for CD but above a re-defined cut-off in the context of GA underwent MR spectroscopy at baseline and after a GFD.<br />Results: Twenty-one consecutive patients with GA were included. Ten were on a strict GFD with elimination of AGA, 5 were on a GFD but continued to have AGA, and 6 patients did not go on a GFD. The NAA/Cr area ratio from the cerebellar vermis increased in all patients on a strict GFD, increased in only 1 out of 5 (20%) patients on a GFD with persisting circulating AGA, and decreased in all patients not on a GFD.<br />Conclusion: Patients with ataxia and low titres of AGA benefit from a strict GFD. The results suggest an urgent need to redefine the serological cut-off for circulating AGA in diagnosing GA.
- Subjects :
- Aged
Aspartic Acid analogs & derivatives
Ataxia chemically induced
Ataxia diet therapy
Ataxia immunology
Biomarkers blood
Celiac Disease blood
Celiac Disease diet therapy
Cerebellum
Creatine
Diet
Gliadin immunology
Glutens immunology
Humans
Magnetic Resonance Spectroscopy methods
Middle Aged
Reference Values
Ataxia diagnosis
Diet, Gluten-Free
Glutens adverse effects
Immunoglobulin A blood
Subjects
Details
- Language :
- English
- ISSN :
- 2072-6643
- Volume :
- 10
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Nutrients
- Publication Type :
- Academic Journal
- Accession number :
- 30301184
- Full Text :
- https://doi.org/10.3390/nu10101444