Hugh James Freeman*

Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, BC, Canada

*Corresponding Author: Hugh James Freeman, Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, BC, Canada.

Received: July 03, 2023; Published: July 17, 2023

Abstract

Brain white-matter lesions may be detected late in the clinical course of different disorders thought to have an autoimmune pathogenesis, particularly in the pediatric population. Here, a 42 year old male with diarrhea and weight loss was discovered to have adult onset celiac disease. After institution of a gluten-free diet, he responded with resolution of his diarrhea, weight gain and histological improvement. Over a decade later, he was observed to have incidental white-matter lesions in his central nervous system detected with MRI and thought to have resulted from microvascular changes or inflammatory demyelination. This report describes an adult with brain white-matter lesions in well-established celiac disease and failure of a long-term gluten-free diet to prevent their development.

 Keywords: Celiac Disease; Gluten-free Diet; Brain White-Matter Lesions; Demyelination; Vascular Disease; Autoimmune Disease

References

1. Freeman HJ. “Neurological disorders in adult celiac disease”. Canadian Journal of Gastroenterology 22 (2008): 909-911.
2. Therrien A., et al. “Celiac disease: extra intestinal manifestations and associated conditions”. Journal of Clinical Gastroenterology 54 (2020): 8-21.
3. Giuffre M., et al. “Celiac disease and neurological manifestations: from gluten to neuroinflammation”. International Journal of Molecular Sciences 23 (2022): 15564.
4. Kieslich M., et al. “Brain white-matter lesions in celiac disease: a prospective study of 75 diet-treated patients”. Pediatrics 108 (2001): E21.
5. Freeman HJ. “Mucosal recovery and mucosal healing in biopsy defined adult celiac disease”. International Journal of Celiac Disease 5 (2017): 40-42.
6. Turner MR., et al. “Autoimmune disease preceding amyotrophic lateral sclerosis”. Neurology 81 (2013): 1222-1225.
7. Brown KJ., et al. “White matter lesions suggestive of amyotrophic lateral sclerosis attributed to celiac disease”. AJNR American Journal of Neuroradiology 31 (2010): 880-881.
8. Turner M.R., et al. “A case of celiac disease mimicking amyotrophic lateral sclerosis”. Nature Clinical Practice Neurology 3 (2007): 581-584.
9. Ham H., et al. “A case of celiac disease with neurologic manifestations misdiagnosed as amyotrophic lateral sclerosis”. Intestinal Research 15 (2017): 540-542.
10. Ludvigsson JF., et al. “No association between biopsy-verified celiac disease and subsequent amyotrophic lateral sclerosis—a population based cohort study”. European Journal of Neurology 21 (2014): 976-982.
11. Visser AE., et al. “No association between gluten sensitivity and amyotrophic lateral sclerosis”. Journal of Neurology 264 (2017): 694-700.

Citation

Citation: Hugh James Freeman. “White-Matter Lesions in the Central Nervous System in Biopsy-Defined Adult Celiac Disease”.Acta Scientific Medical Sciences 7.8 (2023): 115-117.

Copyright

Copyright: © 2023 Hugh James Freeman. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.