Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Hadjivassiliou, Marios, Grünewald, Richard A, Sanders, David S, Zis, Panagiotis, Croall, Iain, Shanmugarajah, Priya D, Sarrigiannis, Ptolemaios G, Trott, Nick, Wild, Graeme, Hoggard, Nigel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
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
_version_ 1783367854492483584
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
work_keys_str_mv AT hadjivassilioumarios thesignificanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia
AT grunewaldricharda thesignificanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia
AT sandersdavids thesignificanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia
AT zispanagiotis thesignificanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia
AT croalliain thesignificanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia
AT shanmugarajahpriyad thesignificanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia
AT sarrigiannisptolemaiosg thesignificanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia
AT trottnick thesignificanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia
AT wildgraeme thesignificanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia
AT hoggardnigel thesignificanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia
AT hadjivassilioumarios significanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia
AT grunewaldricharda significanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia
AT sandersdavids significanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia
AT zispanagiotis significanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia
AT croalliain significanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia
AT shanmugarajahpriyad significanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia
AT sarrigiannisptolemaiosg significanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia
AT trottnick significanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia
AT wildgraeme significanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia
AT hoggardnigel significanceoflowtitreantigliadinantibodiesinthediagnosisofglutenataxia