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标题：The Significance of Low Titre Antigliadin Antibodies in the Diagnosis of Gluten Ataxia
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作者：Marios Hadjivassiliou ; Richard A Grünewald ; David S Sanders 等
期刊名称：Nutrients
电子版ISSN：2072-6643
出版年度：2018
卷号：10
期号：10
页码：1444-1450
DOI：10.3390/nu10101444
出版社：MDPI Publishing
摘要：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.
关键词：Gluten ataxia; antigliadin antibodies; coeliac disease; MR spectroscopy; gluten sensitive enteropathy; antigliadin antibody titre