Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 24 November 2017

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Focal white-matter lesions in brain represent extraintestinal symptom of celiac disease?

A report published in the journal Pediatrics has shed light on a previously unrecognized event occurring in the brains of sufferers of celiac disease.

News image

fiogf49gjkf04

Celiac disease (CD), or gluten sensitivity, is considered to be a state of heightened immunologic responsiveness to ingested gluten proteins in genetically predisposed individuals.

The disease manifests in the gastrointestinal tract as a severe enteropathy of the small intestine, with malabsorption, steatorrhea, and weight loss because of a deranged mucosal immune response.

Neurologic complications also occur, especially epilepsy. This may be associated with occipital calcifications or folate deficiency and cerebellar ataxia.

Focal white-matter lesions may be extraintestinal manifestation of celiac disease.
Pediatrics

There have been reports of brain white-matter lesions as an extraintestinal manifestation in Crohn's disease and ulcerative colitis, but not in CD.

A study conducted by the Departments of Pediatrics and Neuroradiology, at the Johann Wolfgang Goethe University, in Frankfurt/Main, Germany, has examined 75 diet-treated pediatric patients with biopsy-proven CD.

The patients who enrolled into the prospective study underwent clinical neurologic examinations, laboratory investigations, electroencephalography, computed tomography, and magnetic resonance imaging.

Each patient had been exposed to gluten for a mean period of 2.4 years, and ranged in age from 2.8 to 24.2 years (mean age 11.6 years).

Neurologic findings were identified in 10 patients. These included febrile seizures, single generalized seizures, mild ataxia, and muscular hypotonia with retarded motor development.

The study found no folate deficiencies, and hippocampal regions showed no abnormalities.

Computed tomography did not reveal any cerebral calcifications, but magnetic resonance imaging detected unilateral and bilateral T2-hyperintensive white-matter lesions in 15 patients.

There was no correlation between these lesions and dietary compliance, or neurologic or electroencephalographic abnormalities.

Although the mean gluten exposure time of these patients was slightly increased, this was not significant.

The research team concludes from their investigations that focal white-matter lesions in the brain may represent an extraintestinal manifestation of CD.

They add that these lesions may be ischemic in origin, as a result of a vasculitis, or caused by inflammatory demyelination.

Also, they seem to be more typical of pediatric CD than cerebral calcifications.

Although the group caution that the prognostic value of focal white-matter lesions in the brain is unclear, and needs to be elucidated in additional studies, they finish by saying that CD should be suggested as a differential diagnosis in children with unclear white-matter lesions, even without intestinal symptoms.

Pediatrics 2001; 108 (2): e21
16 August 2001

Go to top of page Email this page Email this page to a colleague

 24 November 2017 
Osteoporotic fractures in Barrett's esophagus
 24 November 2017 
Center ERCP volume and procedure success
 24 November 2017 
Adipokines and IBD
 23 November 2017 
Pharmacological management of GERD
 23 November 2017 
Incidence of biopsy-verified celiac disease
 23 November 2017 
Distance travelling for rectal cancer outcomes
 22 November 2017 
Challenges of US-trained gastroenterologists when abroad
 22 November 2017 
Surgical treatment delays influence survival in colon cancer
 22 November 2017 
Golimumab in Crohn's disease
 21 November 2017 
Preoperative optimization in IBD patients
 21 November 2017 
Cholangiopathy in critically ill patients
 21 November 2017 
Prepregnancy obesity and maternal mortality
 20 November 2017 
Barriers to hepatitis C treatment
 20 November 2017 
Socioeconomic characteristics in diverticular disease
 20 November 2017 
Endoscopic indices of disease activity for Crohn’s
 17 November 2017 
Food elimination diets for treatment of adults with eosinophilic esophagitis
 17 November 2017 
PPI use and cognitive function in women
 17 November 2017 
Predicting microscopic colitis
 16 November 2017 
NAFLD-hepatocellular carcinoma and survival after orthotopic liver transplant
 16 November 2017 
Prepregnancy obesity and severe maternal morbidity
 16 November 2017 
Celiac disease screening in adult first-degree relatives
 15 November 2017 
Breastfeeding and the risk of IBD
 15 November 2017 
Predicting recurrence after curative rectal cancer surgery
 15 November 2017 
Medication nonadherence and health care costs
 14 November 2017 
Eosinophilic gastroenteritis and colitis
 14 November 2017 
HBV/HCV coinfection and cirrhosis
 14 November 2017 
Sexual dysfunction after rectal cancer surgery
 13 November 2017 
Genetic polymorphisms, fatty acids and ulcerative colitis
 13 November 2017 
Flares after immunomodulator withdrawal in Crohn's
 13 November 2017 
GI bleeding in patients taking non–vitamin K antagonist oral anticoagulants
 10 November 2017 
Thiopurines vs TNF and lymphoma risk in IBD
 10 November 2017 
Drug monitoring of anti-tumour necrosis factor therapy in IBD
 10 November 2017 
Treatment decisions for older patients with colorectal cancer
 09 November 2017 
Quality standards in upper gastrointestinal endoscopy
 09 November 2017 
Irradiated rectal cancer and chemoradiotherapy
 09 November 2017 
Environmental factors and IBD
 08 November 2017 
Prophylaxis of spontaneous bacterial peritonitis
 08 November 2017 
Optimal management of postoperative Crohn's disease
 07 November 2017 
Community Screening for Helicobacter pylori
 07 November 2017 
Early readmission in IBD patients
 07 November 2017 
Mesocolic excision for colon cancer
 06 November 2017 
Food elimination diet for children with eosinophilic esophagitis
 06 November 2017 
Biologic agents and obesity in children with IBD
 06 November 2017 
Liver cancer burden despite extensive use of antiviral agents
 03 November 2017 
Statins and mortality in chronic viral hepatitis
 03 November 2017 
Propofol for outpatient colonoscopy
 03 November 2017 
Asthma and IBD development
 02 November 2017 
Diverticulitis and emergency department burden
 02 November 2017 
Rural residence and risk of IBD
 02 November 2017 
Sexual functioning in Hep C
 01 November 2017 
Autoimmune pancreatitis in children
 01 November 2017 
Heartburn relief in adolescents with GERD
 31 October 2017 
Follow-up of positive results on fecal blood tests
 31 October 2017 
Surveillance in ulcerative colitis and Crohn’s disease
 30 October 2017 
Local recurrence after curative rectal cancer surgery
 30 October 2017 
Low-flow ascites pump in refractory cirrhosis
 30 October 2017 
Medical therapy of patients with pediatric-onset IBD
 27 October 2017 
NAFLD in advanced fibrosis in the USA
 27 October 2017 
Early readmission in cirrhosis after bacterial infections
 26 October 2017 
Predicting response to anti-TNF therapy in Crohn's

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2017 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us