Anti-gliadin Antibodies and Gluten Neuropathies: A Borderline Link

Abstract

The aim of this research was to estimate the prevalence of gluten sensitivity in neurologic diseases of unknown etiology and to determine their clinical and biological characteristics in a Moroccan population. Patients and Methods: A prospective case-control study was performed on 60 patients and 57 controls. Patients and controls underwent a screening for IgG and IgA anti-gliadin antibodies (ELISA anti-Gliadin, Orgentec, threshold: 12 IU/ml), and IgA anti-tissue transglutaminase antibodies (ELISA IgA-tGTA, DRG, threshold: 10 IU/m).  Results: The median age of patients was 43±13.91 years (ranges: 13-67), versus 39.4±9.12 (ranges: 19-58) for controls. Male to female sexe-ratio was 0.7 for patients vs 2.1 for controls. IgG and/or IgA anti-gliadin antibodies (AGA) were positive in 26.7% of cases (n=16) vs 15.8% (n=9) in controls (p=0.15), while IgA-tTGA was negative in all patients, but positive in 1 control. Positive AGA cases corresponded to peripheral neuropathy (n=4), ataxia (n=3), ischemic stroke (n=3), myopathy (n=2), and 1 case for each of the following conditions: multiple sclerosis, epilepsy, cerebral thrombophlebitis and myelopathy. Among the positive AGA cases, IgA isotype was more prevalent, but IgG AGA titers were higher and clinically more relevant. Conclusion: Gluten Sensitivity is a potential cause of unknown etiological neurologic diseases in young adults, particularly peripheral neuropathy, ataxia and ischemic stroke. AGA testing especially IgG isotype might be a suitable marker to screen for gluten neuropathies.