The Significance of Low Titre Antigliadin Antibodies in the Diagnosis of Gluten Ataxia
AbstractBackground: 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. View Full-Text
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Hadjivassiliou, M.; Grünewald, R.A.; Sanders, D.S.; Zis, P.; Croall, I.; Shanmugarajah, P.D.; Sarrigiannis, P.G.; Trott, N.; Wild, G.; Hoggard, N. The Significance of Low Titre Antigliadin Antibodies in the Diagnosis of Gluten Ataxia. Nutrients 2018, 10, 1444.
Hadjivassiliou M, Grünewald RA, Sanders DS, Zis P, Croall I, Shanmugarajah PD, Sarrigiannis PG, Trott N, Wild G, Hoggard N. The Significance of Low Titre Antigliadin Antibodies in the Diagnosis of Gluten Ataxia. Nutrients. 2018; 10(10):1444.Chicago/Turabian Style
Hadjivassiliou, Marios; Grünewald, Richard A.; Sanders, David S.; Zis, Panagiotis; Croall, Iain; Shanmugarajah, Priya D.; Sarrigiannis, Ptolemaios G.; Trott, Nick; Wild, Graeme; Hoggard, Nigel. 2018. "The Significance of Low Titre Antigliadin Antibodies in the Diagnosis of Gluten Ataxia." Nutrients 10, no. 10: 1444.
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