谷蛋白敏感与视神经脊髓炎:2例报道

• 作 者: Jacob S. Zarei M. Kenton A. Allroggen H. 方伯言
• 机 构: Department of Neurology Walsgrave Hospital University Hospitals of Coventry and Warwickshire NHS Tr
• 出 处: 世界核心医学期刊文摘(神经病学分册)
• 发表日期: 2005年10期
• 关键词: 视神经脊髓炎 谷蛋白 肠道症状 多发性硬化症 抗麦胶蛋白抗体 小脑共济失调 脊髓病 神经系统并发症 腹部疾病 视神经炎

Neuromyelitis optica is a clinical syndrome characterised by acute transverse myelitis plus an acute or subacute optic neuritis with or without recovery. Alt hough once believed to be a variant of multiple sclerosis, diagnostic criteria h ave recently been proposed for neuromyelitis optica, making it a clinically dist inct syndrome. The term gluten sensitivity refers to a state of heightened immun ological responsiveness to ingested gluten in genetically susceptible individual s, as indicated by circulating antibodies to gliadin. Several neurological compl ications have been described associated with gluten sensitivity ranging from per ipheral neuropathy and cerebellar ataxia to an increased risk of epilepsy. Altho ugh myelopathy has been described in some case reports of coeliac disease, neuro myelitis optica has never been described in association with gluten sensitivity. We describe two cases of gluten sensitivity presenting as neuromyelitis optica with no previous history of significant gastrointestinal symptoms. Gluten sensit ivity was confirmed by immunological and histological studies.

Neuromyelitis optica is a clinical syndrome characterised by acute transverse myelitis plus an acute or subacute optic neuritis with or without recovery. Alt hough once believed to be a variant of multiple sclerosis, diagnostic criteria h ave recently been proposed for neuromyelitis optica, making it a clinically dist inct syndrome. The term gluten sensitivity refers to a state of heightened immunological ness ness ness ness ication to ingested gluten in genetically susceptible individuals s, as marked by circulating antibodies to gliadin. Several neurological compl ications have been described associated with gluten sensitivity ranging from per ipheral neuropathy and cerebellar ataxia to an increased risk of epilepsy. Altho ugh myelopathy has been described in some case reports of coeliac disease, neuro myelitis optica has never been described in association with gluten sensitivity. We describe two cases of gluten sensitivity presenting as neuromyelitis optica with no previous history of signif icant gastrointestinal symptoms. Gluten sensitvity was confirmed by immunological and histological studies.