Buge A, Escourolle R, Rancurel G, Hauw J J, Denvil D, Bernier J J, Rambaud J, Modigliani R
Rev Neurol (Paris). 1979 Nov;135(10):719-31.
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.
三名麸质敏感性肠病患者在遵循无麸质饮食治愈消化系统疾病很长时间后出现了神经肌肉病变。这些病例与典型的营养缺乏性神经病有根本不同，其神经和肌肉存在微血管炎性病变。所有3例患者的症状学表现相似，其特征是最大有髓神经纤维至后支的病变体征与肌肉病变相关联。皮质激素治疗改善了病情，但未影响其慢性病程。神经和肌肉活检显示存在节段性微血管炎，主要为淋巴细胞-组织细胞性。这些组织学改变的可能机制是循环免疫复合物的改变，通常见于麸质敏感性肠病，可导致各种相关疾病。其中一些免疫复合物可能与对麸质的消化不耐受并无直接关系，但在无麸质饮食期间会持续存在，并可能导致微血管炎。
