Gluten ataxia (GA) has customarily been considered to be the main neurological manifestation of celiac disease (CD). In recent years, the condition of non-celiac gluten sensitivity (NCGS) has been defined, which includes some patients who are not considered "true celiacs." We performed a comparative clinicopathological study of these three entities. We studied 31 GA, 48 CD and 37 NCGS patients, prospectively in the same center for a period of 7 years. The protocol study included two serological determinations for gluten sensitivity [anti-gliadin IgA and IgG (AGA) and anti-tissue transglutaminase IgA (TG) antibodies], HLA-DQ2 typing, and duodenal histological assessment. Demographics and investigative findings were compared. Females were 55 % in GA, 75 % in CD (p < 0.001), and 47 % in NCGS (N.S.). GA patients were older (59 ± 14 years) than CD (43 ± 13 years) and NCGS (41 ± 8 years) groups (p < 0.001). AGA positivity was higher in GA (100 %) than in CD (48 %) groups (p < 0.001), but similar to NCGS patients (89 %; N.S.); TG positivity was lower in GA (3.2 %) than in CD (33.3 %; p < 0.001), but similar to NCGS (2.7 %; N.S.). DQ2 (+) was lower in GA (32.2 %) than in CD (89.6 %; p < 0.001), but similar to NCGS (29.7 %; N.S.). Lymphocytic enteritis (Marsh type 1) was lower in GA (9.6 %) than in CD (66.7 %; p < 0.001), but similar to NCGS (10.8 %; N.S.). The other gluten sensitivity-related characteristics measured were different to CD patients, but very close to NCGS. We conclude that GA patients are better classified within the NCGS group, than within CD.

2nd Department of Internal Medicine Faculty of Medicine Masaryk University Brno Czech Republic

Clinica Medica 1 Fondazione IRCCS Policlinico San Matteo Università degli Studi di Pavia Pavia Italy

Department of Pharmacology and Toxicology Faculty of Pharmacy Comenius University Odborarov 10 832 32 Bratislava Slovak Republic

Gastroenterology Unit Central University Hospital of Asturias Oviedo Spain

School of Medicine University of Oviedo Julian Clavería s no 33006 Oviedo Spain

See more in PubMed

Biol Psychiatry. 2010 Jul 1;68(1):100-4 PubMed

Am J Gastroenterol. 2012 Dec;107(12):1898-906; quiz 1907 PubMed

Mol Med Rep. 2013 Oct;8(4):1079-83 PubMed

Therap Adv Gastroenterol. 2012 Jan;5(1):37-47 PubMed

Gastroenterology Res. 2011 Dec;4(6):268-276 PubMed

Cell Mol Life Sci. 2015 Apr;72(7):1317-29 PubMed

Neurologist. 2006 Nov;12(6):318-21 PubMed

J Neurol. 2012 May;259(5):851-4 PubMed

Eur J Gastroenterol Hepatol. 1999 Oct;11(10):1185-94 PubMed

Ann Med. 2001 Sep;33(6):445-9 PubMed

Brain. 2001 May;124(Pt 5):1013-9 PubMed

Lancet. 1998 Nov 14;352(9140):1582-5 PubMed

Nutrients. 2013 Sep 26;5(10):3839-53 PubMed

Acta Psychiatr Scand. 2006 Feb;113(2):82-90 PubMed

Scand J Gastroenterol. 2008;43(11):1311-4 PubMed

Ann Intern Med. 2012 Feb 21;156(4):309-11 PubMed

J Neurol Neurosurg Psychiatry. 1999 Jan;66(1):32-5 PubMed

Brain. 2002 May;125(Pt 5):961-8 PubMed

N Engl J Med. 2007 Oct 25;357(17):1731-43 PubMed

Curr Treat Options Neurol. 2005 Jan;7(1):43-48 PubMed

Gastroenterology. 1992 Jan;102(1):330-54 PubMed

Lancet. 1978 Jun 24;1(8078):1358-9 PubMed

Gut. 2013 Jan;62(1):43-52 PubMed

J Child Neurol. 2010 Jan;25(1):114-9 PubMed

United European Gastroenterol J. 2015 Apr;3(2):146-59 PubMed

PLoS One. 2010 Mar 15;5(3):e9698 PubMed

BMC Med. 2011 Mar 09;9:23 PubMed

Gastroenterology. 2005 Apr;128(4 Suppl 1):S92-7 PubMed

Gastroenterology. 1980 Nov;79(5 Pt 1):801-6 PubMed

Brain. 2003 Mar;126(Pt 3):685-91 PubMed

BMC Med. 2012 Feb 07;10:13 PubMed

J Neurol Neurosurg Psychiatry. 2003 Sep;74(9):1221-4 PubMed

Am J Gastroenterol. 2009 Jun;104(6):1587-94 PubMed

Clin Gastroenterol Hepatol. 2005 Sep;3(9):843-51 PubMed

Gastroenterology. 2013 Aug;145(2):320-8.e1-3 PubMed

N Engl J Med. 2012 Dec 20;367(25):2419-26 PubMed