Jacob S, Zarei M, Kenton A, Allroggen H
Department of Neurology, University Hospitals of Leicester NHS Trust, Royal Infirmary, UK.
J Neurol Neurosurg Psychiatry. 2005 Jul;76(7):1028-30. doi: 10.1136/jnnp.2004.055491.
Neuromyelitis optica is a clinical syndrome characterised by acute transverse myelitis plus an acute or subacute optic neuritis with or without recovery. Although once believed to be a variant of multiple sclerosis, diagnostic criteria have recently been proposed for neuromyelitis optica, making it a clinically distinct syndrome. The term gluten sensitivity refers to a state of heightened immunological responsiveness to ingested gluten in genetically susceptible individuals, as indicated by circulating antibodies to gliadin. Several neurological complications have been described associated with gluten sensitivity ranging from peripheral neuropathy and cerebellar ataxia to an increased risk of epilepsy. Although myelopathy has been described in some case reports of coeliac disease, neuromyelitis optica has never been described in association with gluten sensitivity. We describe two cases of gluten sensitivity presenting as neuromyelitis optica with no previous history of significant gastrointestinal symptoms. Gluten sensitivity was confirmed by immunological and histological studies.
视神经脊髓炎是一种临床综合征，其特征为急性横贯性脊髓炎加急性或亚急性视神经炎，可有或无恢复情况。尽管曾一度被认为是多发性硬化的一种变体，但最近已提出视神经脊髓炎的诊断标准，使其成为一种临床上独特的综合征。麸质敏感性是指在遗传易感性个体中，对摄入的麸质产生增强的免疫反应状态，这可通过抗麦醇溶蛋白循环抗体来表明。已经描述了几种与麸质敏感性相关的神经系统并发症，范围从周围神经病变和小脑共济失调到癫痫风险增加。尽管在一些乳糜泻病例报告中描述过脊髓病，但从未有过视神经脊髓炎与麸质敏感性相关的描述。我们描述了两例表现为视神经脊髓炎的麸质敏感性病例，此前无明显胃肠道症状史。通过免疫学和组织学研究证实了麸质敏感性。
