Department of Neurology, Royal Hallamshire Hospital, Sheffield, UK.
Lancet Neurol. 2010 Mar;9(3):318-30. doi: 10.1016/S1474-4422(09)70290-X.
Gluten sensitivity is a systemic autoimmune disease with diverse manifestations. This disorder is characterised by abnormal immunological responsiveness to ingested gluten in genetically susceptible individuals. Coeliac disease, or gluten-sensitive enteropathy, is only one aspect of a range of possible manifestations of gluten sensitivity. Although neurological manifestations in patients with established coeliac disease have been reported since 1966, it was not until 30 years later that, in some individuals, gluten sensitivity was shown to manifest solely with neurological dysfunction. Furthermore, the concept of extraintestinal presentations without enteropathy has only recently become accepted. In this Personal View, we review the range of neurological manifestations of gluten sensitivity and discuss recent advances in the diagnosis and understanding of the pathophysiological mechanisms underlying neurological dysfunction related to gluten sensitivity.
麸质敏感性是一种具有多种表现的系统性自身免疫性疾病。这种疾病的特征是，在遗传易感个体中，对摄入的麸质产生异常免疫反应。乳糜泻或麸质敏感性肠病仅是麸质敏感性的一系列可能表现之一。尽管自 1966 年以来就有报道称患有确诊乳糜泻的患者存在神经表现，但直到 30 年后，人们才发现，在某些个体中，麸质敏感性仅表现为单纯的神经功能障碍。此外，最近才接受了没有肠病的肠外表现的概念。在这篇个人观点中，我们回顾了麸质敏感性的一系列神经表现，并讨论了与麸质敏感性相关的神经功能障碍的诊断和对其病理生理机制的理解方面的最新进展。
