Gluten and Neuroimmunology. Rare association with Myasthenia Gravis and Literature Review.
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
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
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 |
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.