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Gluten and Neuroimmunology. Rare association with Myasthenia Gravis and Literature Review.

Revista da Associacao Medica Brasileira (1992)
April 1, 2018
Francisco Oliveira et al. (4 authors)
Case ReportsJournal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to explore the association between gluten-related disorders (celiac disease and non-celiac gluten sensitivity) and autoimmune manifestations, particularly myasthenia gravis, and the role of a Gluten-Free Diet in symptom improvement.

Results Summary

The study found that gluten-related disorders can present with various immune-mediated morbidities, including rare associations like myasthenia gravis. A Gluten-Free Diet was noted to improve symptoms in non-celiac gluten sensitivity cases without enteropathy.

Population

A young female patient initially presenting with peripheral neuropathy, later developing symptoms of immune-mediated morbidities.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (3)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Gluten Free Diet (GFD)
decrease
symptoms
patients without signs of enteropathy in duodenal biopsy
-
improvement in symptoms
#1
-
increase
myasthenia gravis (MG)
patients with celiac disease (CD)
-
may occur more often
#2
-
neutral
a second autoimmune disorder
Between 13 to 22% of the patients with MG
13 to 22%
have
#3
Abstract

As the celiac disease (CD), the non-celiac gluten sensitivity (NCGS) has also been associated with several autoimmune manifestations. It is rarely associated with myasthenia gravis (MG). This paper shall introduce the case of a young female patient, initially presenting a peripheral neuropathy framework. During clinical and neurological follow-up, she began to present symptoms of various immune-mediated morbidities. Diseases related to gluten represent a clinical spectrum of manifestations with a trigger in common, the ingestion of gluten. CD is the most well-known and serious disease of the spectrum, also called gluten-sensitive enteropathy. The NCGS is diagnosed from clinical evidence of improvement in symptoms followed by a Gluten Free Diet (GFD) in patients without signs of enteropathy in duodenal biopsy. There are indications that, although rare, with a prevalence of 1 in 5000, myasthenia gravis (MG) may occur more often when CD is also present. Between 13 to 22% of the patients with MG have a second autoimmune disorder. However, it is often associated with dermatomyositis or polymyositis, lupus erythematosussystemic lupus erythematosus, Addison's disease, Guillain-Barré syndrome and juvenile rheumatoid arthritis. Thus, the symptoms of neuromuscular junction involvement may give a diagnostic evidence of this rare association.

Medical Subject Headings (MeSH)
AdultAtaxiaCerebellar DiseasesCholinesterase InhibitorsFemaleFood HypersensitivityGlutensHumansMagnetic Resonance ImagingMyasthenia GravisNeuroimmunomodulationPyridostigmine BromideVitamin B 12 Deficiency
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality50/10
Citation Metrics
Total Citations1
Citations/Year0.1
Relative Citation Ratio0.05
NIH Percentile2.8%
Research Impact Scores
APT Score0.05
Weight Score1.34
Normalized Score0.56
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