The Significance of Low Titre Antigliadin Antibodies in the Diagnosis of Gluten Ataxia
| Autor: | Hadjivassiliou, Marios, Grünewald, Richard A., Sanders, David S., Zis, Panagiotis, Croall, Iain, Shanmugarajah, Priya D., Sarrigiannis, Ptolemaios G., Trott, Nick, Wild, Graeme, Hoggard, Nigel |
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| Přispěvatelé: | Zis, Panagiotis [0000-0001-8567-3092], Sarrigiannis, Ptolemaios G. [0000-0002-8380-8755], Hadjivassiliou, Marios [0000-0003-2542-8954] |
| Rok vydání: | 2018 |
| Předmět: |
In vivo magnetic resonance spectroscopy
antigliadin antibody titre Magnetic Resonance Spectroscopy antigliadin antibodies Gastroenterology Coeliac disease Gliadin Serology 0302 clinical medicine Reference Values Cerebellum Enteropathy reproductive and urinary physiology chemistry.chemical_classification Nutrition and Dietetics MR spectroscopy Middle Aged female genital diseases and pregnancy complications 030211 gastroenterology & hepatology medicine.symptom lcsh:Nutrition. Foods and food supply medicine.medical_specialty Ataxia Glutens education lcsh:TX341-641 Context (language use) Article 03 medical and health sciences Diet Gluten-Free Internal medicine medicine Humans Aged Aspartic Acid business.industry medicine.disease Creatine Gluten Diet Immunoglobulin A Food intolerance body regions Celiac Disease chemistry gluten sensitive enteropathy business 030217 neurology & neurosurgery Biomarkers coeliac disease Food Science Gluten ataxia |
| Zdroj: | Nutrients Volume 10 Issue 10 Nutrients, Vol 10, Iss 10, p 1444 (2018) |
| ISSN: | 2072-6643 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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