Neurological Symptoms of Celiac Disease

A recent article in The New York Times reported on celiac disease, an autoimmune disorder of the gut triggered by the gluten proteins in wheat and other grains, and its connection to the human brain. Upon analysis of several cases, treating an autoimmune disease of the gut (by avoiding gluten) resolved what looked like a debilitating disorder of the brain. According to the article, in some subset of patients, apparent neurological symptoms could signal undiagnosed celiac disease.

While celiac disease symptoms are often associated with the gut, they can actually go well beyond that. Some scientists now suspect that the autoimmune firestorm ignited in the gut may descend on other organs, including the brain. According to the article, around 10 percent of people with celiac disease, and possibly more, are thought to suffer neurological symptoms, ranging from headache and nerve pain, to ataxia and to epilepsy.

Autoimmune diseases of the central nervous system are also being identified in many other areas. In fact, at Mayo Clinic's Neuroimmunology Clinic, patients with autoimmune epilepsy, dementia and other recently described autoimmune disorders are frequently “cured” with immunotherapies, which usually involve some combination of steroidal immune-suppressants, intravenous immunoglobulin-G, which consists of antibodies from donors, and plasmapheresis, a procedure that removes antibodies from the blood.

Sean Pittock, M.D.
Sean Pittock, M.D.

According to Sean Pittock, M.D., a neurologist at Mayo Clinic, one-tenth of samples usually come back positive for the self-directed antibodies indicative of autoimmunity. While many of these patients have cancer, which can trigger an attack, a fraction have an autoimmune disease of the brain.

Dr. Pittock goes on to explain, "There are people out there who are very ill and in nursing homes, and their condition is treatable and reversible. And they’re being missed." Dr. Pittock estimates these patients to number in the many thousands.

McKeonAndrew
Andrew McKeon, M.B., B.Ch., M.D.

However, some experts caution that resolving neurological symptoms associated with celiac disease may require more treatment than just a gluten-free diet. According to Mayo Clinic neuroimmunologist Dr. McKeon, rather than celiac disease driving autoimmune brain problems, distinct autoimmune diseases are likely to cluster in the same individual. A recent study conducted by Dr. Andrew McKeon found copper deficiencies in celiac patients with neurological problems, while others had autoimmune diseases of the central nervous system. A relative minority — six of 33 — saw neurological improvements on a gluten-free diet. This indicates that avoiding gluten may not entirely mend these patients.

Read the full article to learn more about the connection between autoimmune neurological disorders and celiac disease.

 

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Kelley Schreiber

Kelley Schreiber is a Marketing Channel Manager at Mayo Medical Laboratories. She is the principle editor and writer of Insights and leads social media and direct marketing strategy. Kelley has worked at Mayo Clinic since 2013. Outside of work, you can find Kelley running, traveling, playing with her new kitten, and exploring new foods.