1. Myopathy associated with gluten sensitivity.
- Author
-
Hadjivassiliou M, Chattopadhyay AK, Grünewald RA, Jarratt JA, Kandler RH, Rao DG, Sanders DS, Wharton SB, and Davies-Jones GA
- Subjects
- Adolescent, Adult, Age of Onset, Aged, Ataxia etiology, Ataxia physiopathology, Celiac Disease physiopathology, Cohort Studies, Creatine Kinase blood, Electromyography, Female, Food, Formulated, Glutens adverse effects, Humans, Immunotherapy, Male, Middle Aged, Muscle Fibers, Skeletal pathology, Muscle, Skeletal metabolism, Muscle, Skeletal pathology, Muscular Diseases therapy, Myositis, Inclusion Body etiology, Myositis, Inclusion Body pathology, Myositis, Inclusion Body physiopathology, Neural Conduction physiology, Peripheral Nervous System Diseases etiology, Peripheral Nervous System Diseases physiopathology, Treatment Outcome, Celiac Disease complications, Muscle, Skeletal physiopathology, Muscular Diseases etiology, Muscular Diseases physiopathology
- Abstract
Ataxia and peripheral neuropathy are the most common neurological manifestations of gluten sensitivity. Myopathy is a less common and poorly characterized additional neurological manifestation of gluten sensitivity. We present our experience with 13 patients who presented with symptoms and signs suggestive of a myopathy and in whom investigation led to the diagnosis of gluten sensitivity. Three of these patients had a neuropathy with or without ataxia in addition to the myopathy. The mean age at onset of the myopathic symptoms was 54 years. Ten patients had neurophysiological evidence of myopathy. Inflammatory myopathy was the most common finding on neuropathological examination. One patient had basophilic rimmed vacuoles suggestive of inclusion-body myositis. Six patients received immunosuppressive treatment in addition to starting on a gluten-free diet; five improved and one remained unchanged. Among seven patients not on immunosuppressive treatment, four showed clinical improvement of the myopathy with a gluten-free diet. The improvement was also associated with reduction or normalization of serum creatine kinase level. The myopathy progressed in one patient who refused the gluten-free diet. Myopathy may be another manifestation of gluten sensitivity and is likely to have an immune-mediated pathogenesis. A gluten-free diet may be a useful therapeutic intervention.
- Published
- 2007
- Full Text
- View/download PDF