Reversible inflammatory and vacuolar myopathy with vitamin E deficiency in celiac disease

@article{Kleopa2005ReversibleIA,
  title={Reversible inflammatory and vacuolar myopathy with vitamin E deficiency in celiac disease},
  author={Kleopas A Kleopa and Kyriacos C. Kyriacou and Eleni Zamba-Papanicolaou and Theodoros Kyriakides},
  journal={Muscle \& Nerve},
  year={2005},
  volume={31}
}
We report a patient with late‐onset celiac disease and neurological manifestations including myopathy, polyneuropathy, and ataxia. Laboratory investigations showed anti‐gliadin antibodies and severe vitamin E deficiency. Muscle biopsy revealed inflammatory infiltrates and rimmed vacuoles, similar to those found in inclusion‐body myositis. A gluten‐free diet and vitamin E supplementation reversed both the clinical neurological manifestations and the abnormalities in the muscle biopsy. Anti… 
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An immune mediated pathogenesis for gluten-related neurological disorders is suggested, with changes observed in muscle in myopathy and in cerebrum of patients with encephalopathy and patients with epilepsy.
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The experience with 13 patients who presented with symptoms and signs suggestive of a myopathy and in whom investigation led to the diagnosis of gluten sensitivity shows clinical improvement of the myopathy with a gluten‐free diet.
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    Alternative medicine review : a journal of clinical therapeutic
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This review explores the etiology and pathology of celiac disease, presents support for the relationship between gluten and other diseases, and provides effective screening and treatment protocols.
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Many gastrointestinal diseases have extraintestinal manifestations including neurologic involvement, and Prompt recognition of these disorders is vitally important, since many of the neurologic manifestations of gastrointestinal disease are treatable.
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Progress gained from research into sporadic inclusion body myositis indicates that both inflammatory reaction and abnormal protein accumulation are important for the pathogenesis in s-IBM.
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