Şamil HIZLI, Sedat IŞIKAY

Çölyak Hastalığı ve Eşlik Eden Nörolojik Durumlar

Amaç: Çölyak hastalığı bir çok nörolojik hastalık ile ilişkilendirilmiştir. Bu çalışmada, Çölyak hastalığı ve eşlik eden nörolojik semptomları olan 16 farklı hastayı sunuyoruz. Bu yazıda, Çölyak hastalığının nörolojik yüzüne dikkat çekmek için güncel literatür ışığında Çölyak hastalığının genel nörolojik özelliklerini tartışmayı amaçladık.Gereç ve Yöntemler: Hastanemizde 2010-2012 yılları arasında Çölyak hastalığı tanısı almış tüm hastaların tıbbi kayıtları geriye dönük olarak incelendi.Bulgular: Onaltı olgunun dokuzu kız iken yedisi erkek olup yaş ortalamaları 10.34±3.76 yıl idi (5-16 yıl). Çölyak hastalığı olan bu 16 çocukta nörolojik problem olarak epilepsi (n=10), mental retardasyon (n=9), ataksi (n=3), nöropati (n=1), baş ağrısı (n=2), febril konvülziyon (n=1) ve nörofibromatoz tip 1 (n=1) rapor edildi.Sonuç: Çölyak hastalığı birçok farklı nörolojik duruma eşlik edebilir. Anemi, boy kısalığı ve kronik gastrointestinal semptomlar nörolojik hastalığı olan hastalarda maskelenebilir ve çölyak hastalığı tanısını geçiktirebilir.

Anahtar Kelimeler:

Çölyak hastalığı, Çocuk, Nörolojik hastalık, Epilepsi, Nöropati

Celiac Disease and Associated Neurological Conditions

Objective: Celiac disease has been associated with many neurological disorders. In this report, we discuss 16 patients with both celiac disease and neurological symptoms and evaluate the overall neurological features of celiac disease in the light of the current literature to emphasize the neurological aspects of celiac disease.Material and Methods: The medical records of all patients diagnosed with celiac disease between 2010 and 2012 were reviewed.Results: Nine of these 16 cases were female while seven were male with a mean age of 10.34±3.76 years (5-16 years). The reported neurological problems of these 16 children with celiac disease were epilepsy (n=10), mental retardation (n=9), ataxia (n=3), neuropathy (n=1), headache (n=2), febrile seizure (n=1), and neurofi bromatosis type 1 (plus headache) (n=1). Conclusion: Celiac disease may accompany many different neurological conditions. These disorders can share some symptoms such as associated anemia, short stature, and chronic gastrointestinal complaints and the diagnosis of celiac disease may be delayed among patients with neurological disease

Keywords:

Celiac disease, Child, Neurological disease, Epilepsy, Neuropathy,

PDF

___

Celiloğlu C, Karabiber H, Selimoğlu MA. Atypical presentations of celiac disease. Turk J Pediatr 2011;53:241-9.
Ruggieri M, Incorpora G, Polizzi A, Parano E, Spina M, Pavone P. Low prevalence of neurologic and psychiatric manifestations in children with gluten sensitivity. J Pediatr 2008;152:244-9.
Hadjivassiliou M, Grunewald RA, Davis-Jones GA. Gluten sen- sitivity as a neurological illness. J Neurol Neurosurg Psychiatry 2002;72:560-3.
Hershey AD, Winner P, Kabbouche MA, Gladstein J, Yonker M, Lewis D, et al. Use of the ICHD-II criteria in the diagnosis of pediat- ric migraine. Headache 2005;45:1288-97.
Ertekin V, Selimoğlu MA, Kardaş F, Aktaş E. Prevalence of celiac disease in Turkish children. J Clin Gastroenterol 2005;39:689-91.
Finelli PF, McEntee WJ, Ambler M, Kestenbaum D. Adult celiac disease presenting as cerebellar syndrome. Neurology 1980;30: 245-9.
Djuric Z, Kamenov B, Katic V. Celiac disease manifested by polyneuropathy and swollen ankles. World J Gastroenterol 2007;13:2636-8.
Briani C, Zara G, Alaedini A, Grassivaro F, Ruggero S, Toffanin E, et al. Neurological complications of celiac disease and auto- immune mechanisms: A prospective study. J Neuroimmunol 2008;195:171-5.
Ford RP. The gluten syndrome: A neurological disease. Med Hypotheses 2009;73:438-40.
Pratesi R, Gandolfi R, Friedman H, Farage L, De Castro CA, Ca- tassi C. Serum IgA antibodies from patients with coeliac disease react strongly with human brain blood –vessel structures. Scand J Gastroenterol 1998;33:817–22.
Hadjivassiliou M, Gibson A, Davies-jones GAB, Lobo A, Stephen- son TJ, Millford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet 1996;347:369–71.
Kieslich M, Errázuriz G, Posselt HG, Moeller-Hartmann W, Zanella F, Boehles H. Brain white-matter lesions in celiac disease: A pro- spective study of 75 diet-treated patients. Pediatrics 2001;108: 21-5.
Fois A, Vaskotto M, Di Bartolo RM, Di Marco V. Celiac disease and epilepsy in pediatric patients. Childs Nerv Syst 1994;10:450–4.
Chapman RWG, Laidlow JM, Colin-Jones D, Eade OE, Smitj CL. Increased prevalence of epilepsy in coeliac disease. Br Med J 1978;2:250–1.