麸质相关神经系统疾病：病例系列
Gluten-Associated Neurological Disorders: A Cases Series.
作者信息
Bachu Vismaya S, Ghodrati Farinaz, Fogel Brent L, Weiss Guy A
机构信息
Department of Internal Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Celiac Disease Program, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
出版信息
Case Rep Gastroenterol. 2025 May 29;19(1):387-391. doi: 10.1159/000544765. eCollection 2025 Jan-Dec.
INTRODUCTION
Gluten-associated disorders, including celiac disease (CeD) and non-celiac gluten sensitivity (NCGS), can present with various extraintestinal neurologic manifestations, including sensory neuropathy, ataxia, headaches, and seizures.
CASE PRESENTATIONS
In this case series, we present 3 interesting patients with gluten-associated neurological disorders (GAND) across a spectrum of gluten-associated disorders severity, from gluten sensitivity, to CeD, to refractory CeD, illustrating variable presentations and treatment approaches for this underdiagnosed population.
CONCLUSION
For many patients with neurological presentations who initially lack gastrointestinal symptoms, diagnosis remains challenging. Once diagnosed, while a gluten-free diet has been the mainstay of treating GAND for many years, this approach may only prevent progression of disease without reversal of symptoms. Further studies are needed to help guide the development and standardization of treatments for this patient population.
引言
麸质相关疾病，包括乳糜泻（CeD）和非乳糜泻麸质敏感（NCGS），可伴有各种肠外神经表现，包括感觉神经病变、共济失调、头痛和癫痫发作。
病例报告
在本病例系列中，我们展示了3例患有麸质相关神经系统疾病（GAND）的有趣患者，涵盖了从麸质敏感到CeD再到难治性CeD的一系列麸质相关疾病严重程度，说明了这一诊断不足人群的不同表现和治疗方法。
结论
对于许多最初没有胃肠道症状的神经系统表现患者，诊断仍然具有挑战性。一旦确诊，虽然无麸质饮食多年来一直是治疗GAND的主要方法，但这种方法可能只能防止疾病进展，而不能逆转症状。需要进一步研究以帮助指导该患者群体治疗方法的开发和标准化。
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