[Chronic inflammatory neuromyopathies in adults treated for gluten-sensitive enteropathy. A report on three cases with microvascular nerve and muscle lesions (author's transl)]

Rev Neurol (Paris). 1979 Nov;135(10):719-31.
[Article in French]

Abstract

Neuromyopathies developed in three patients with gluten-sensitive enteropathy, a long time after they had been cured of their digestive disease by following a gluten-free diet. These cases differed radically from typical deficiency neuropathies by the presence of microvascular inflammatory lesions in nerves and muscles. The semiological findings were similar in all 3 cases, and were distinguished by the association of signs eveking lesions of the largest myelinated nerves fibers to the posterior rami with lesions in the muscles. Corticotherapy improved the condition but did not affect its chronic course. Nerve and muscle biopsies revealed the presence of segmentary microrascularitis, mainly lymphohistiocytic. The probable mechanism of these histological changes is alterations in the circulating immune-complexes, usually found in gluten-sensitive enteropathy, producing various types of associated disorders. Some of these immune-complexes would not be related straight to digestive intolerance to gluten, but would persist during the gluten-free diet period, and could be responsible for the micro-angiitis.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adult
  • Antigen-Antibody Complex
  • Chronic Disease
  • Diagnosis, Differential
  • Female
  • Glutens / adverse effects*
  • Humans
  • Intestinal Diseases / complications*
  • Intestinal Diseases / diagnosis
  • Intestinal Diseases / diet therapy
  • Middle Aged
  • Muscles / blood supply
  • Muscles / pathology
  • Musculocutaneous Nerve / pathology
  • Myositis / etiology*
  • Myositis / pathology
  • Neuritis / etiology*
  • Neuritis / pathology
  • Polyarteritis Nodosa / diagnosis
  • Vasculitis / etiology
  • Vasculitis / pathology

Substances

  • Antigen-Antibody Complex
  • Glutens