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The Significance of Low Titre Antigliadin Antibodies in the Diagnosis of Gluten Ataxia
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 (G...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213789/ https://www.ncbi.nlm.nih.gov/pubmed/30301184 http://dx.doi.org/10.3390/nu10101444 |
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author | Hadjivassiliou, Marios Grünewald, Richard A Sanders, David S Zis, Panagiotis Croall, Iain Shanmugarajah, Priya D Sarrigiannis, Ptolemaios G Trott, Nick Wild, Graeme Hoggard, Nigel |
author_facet | Hadjivassiliou, Marios Grünewald, Richard A Sanders, David S Zis, Panagiotis Croall, Iain Shanmugarajah, Priya D Sarrigiannis, Ptolemaios G Trott, Nick Wild, Graeme Hoggard, Nigel |
author_sort | Hadjivassiliou, Marios |
collection | PubMed |
description | 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. 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. 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. 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. |
format | Online Article Text |
id | pubmed-6213789 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-62137892018-11-06 The Significance of Low Titre Antigliadin Antibodies in the Diagnosis of Gluten Ataxia Hadjivassiliou, Marios Grünewald, Richard A Sanders, David S Zis, Panagiotis Croall, Iain Shanmugarajah, Priya D Sarrigiannis, Ptolemaios G Trott, Nick Wild, Graeme Hoggard, Nigel Nutrients Article 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. 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. 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. 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. MDPI 2018-10-05 /pmc/articles/PMC6213789/ /pubmed/30301184 http://dx.doi.org/10.3390/nu10101444 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Hadjivassiliou, Marios Grünewald, Richard A Sanders, David S Zis, Panagiotis Croall, Iain Shanmugarajah, Priya D Sarrigiannis, Ptolemaios G Trott, Nick Wild, Graeme Hoggard, Nigel The Significance of Low Titre Antigliadin Antibodies in the Diagnosis of Gluten Ataxia |
title | The Significance of Low Titre Antigliadin Antibodies in the Diagnosis of Gluten Ataxia |
title_full | The Significance of Low Titre Antigliadin Antibodies in the Diagnosis of Gluten Ataxia |
title_fullStr | The Significance of Low Titre Antigliadin Antibodies in the Diagnosis of Gluten Ataxia |
title_full_unstemmed | The Significance of Low Titre Antigliadin Antibodies in the Diagnosis of Gluten Ataxia |
title_short | The Significance of Low Titre Antigliadin Antibodies in the Diagnosis of Gluten Ataxia |
title_sort | significance of low titre antigliadin antibodies in the diagnosis of gluten ataxia |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213789/ https://www.ncbi.nlm.nih.gov/pubmed/30301184 http://dx.doi.org/10.3390/nu10101444 |
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