Gluten Sensitivity in Japanese Patients with Adultonset Cerebellar Ataxia
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概要
- 論文の詳細を見る
Objective: Gluten sensitivity is associated with multiple neurological abnormalities including gluten ataxia, motor neuron diseaselike neuropathy, small fiber type neuropathy, cognitive impairment, and even parkinsonism. We investigated whether or not gluten sensitivity is involved in Japanese patients with idiopathic cerebellar ataxia with extracerebellar presentation. Patients or Materials: Fourteen patients with idiopathic cerebellar ataxia with extracerebellar presentation (autonomic instability, parkinsonism, or pyramidal dysfunction in varying combinations) were screened for antigliadin antibodies (AGA) to analyze for the presence or absence of gluten sensitivity. Patients with typical MR findings of multiple system atrophy of the cerebellar type were excluded. As disease controls without cerebellar ataxia, 9 patients with Parkinsons disease and 18 patients with amyotrophic lateral sclerosis were screened for AGA. Fortyseven normal controls were also screened for AGA. Results: We found a high prevalence of AGA in 5 (36%) of 14 cerebellar ataxia patients, but in only 1 (4%) of 27 disease controls without cerebellar ataxia (odds ratio, 14.4; 95% CI, 1.41147; p<0.05) and in only 1 (2%) of 47 normal controls (odds ratio, 25.6; 95% CI, 2.66246; p<0.001). Among the cerebellar ataxia patients, atypical features such as sensorimotor neuropathy and/or mild cognitive impairment were more prevalent in the AGApositive group (60%) than in the AGAnegative group (0%). In one of the ataxic patients with AGA, a glutenfree diet had positive effects on neurological symptoms and nutritional status. Conclusion: Gluten sensitivity is involved in at least some of the unexplained neurological symptoms of Japanese patients with adultonset, sporadic cerebellar ataxia.
- 社団法人 日本内科学会の論文
著者
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Shimohama Shun
Department Of Neurology Faculty Of Medicine Kyoto University
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Nakase Hiroshi
Department Of Agricultural Chemistry Faculty Of Agriculture Kyoto University
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Tomimoto Hidekazu
Department Of Neurology Faculty Of Medicine Kyoto University
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Sawada Hideyuki
Department Of Anesthesiology Kanagawa Dental College
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Mizutani Kotaro
Department Of Neurology Sakakibara Hakuho Hospital
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Makino Fumi
Department Of Anesthesiology Tokyo Medical And Dental University Graduate School Of Medical And Dent
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Matsui Makoto
Department of Neurology and Clinical Research Center, Center for Neurological Diseases, Utano National Hospital
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Ihara Masafumi
Department of Neurology, Kyoto University Graduate School of Medicine
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Mezaki Takahiro
Department of Neurology, Sakakibara Hakuho Hospital
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Ihara Masafumi
Department of Neurology, Graduate School of Medicine, Kyoto University, Japan
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Nakase Hiroshi
Department of Gastroenterology, Kyoto University Graduate School of Medicine
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Makino Fumi
Department of Neurology, Kyoto University Graduate School of Medicine
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