This is very important in regard to testing for gluten sensitivity when the presenting or sole feature is neurological disease. The antibodies used to screen for celiac disease , Anti-tTG (TG2) and Deamidated Gliadin antibodies, are unlikely to be present. The original Antigliadin antibody test still plays an important role in those who may have gluten sensitivity without enteropathy.
Your doctor will more than likely not know about this important distinction. Be sure the right test is requested on the lab work and ask your doctor to note that it should not be substituted.
Also of note in the paper below is the relatively low positivity of the "celiac" antibodies even in those with enteropathy (only 70-80% in those with enteropathy).
Quote:
J Neuroimmunol. 2010 Nov 5. [Epub ahead of print]
Serology of celiac disease in gluten-sensitive ataxia or neuropathy: Role of deamidated gliadin antibody.
http://www.ncbi.nlm.nih.gov/pubmed/21056914
Rashtak S, Rashtak S, Snyder MR, Pittock SJ, Wu TT, Gandhi MJ, Murray JA.
Department of Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street, SW Rochester, MN 55905, USA.
Abstract
The role and relevance of deamidated gliadin antibodies specific for celiac disease in gluten-sensitive ataxia/neuropathy is unknown. We investigated the association of celiac-specific serology with gluten-sensitive ataxia/neuropathy, in patients with and without gliadin-induced enteropathy. 51 patients with unexplained ataxia/neuropathy suspected to have gluten sensitivity were included in the study and their serum celiac-specific markers were measured. Deamidated gliadin-IgA (83% vs. 22%), deamidated gliadin-IgG (50% vs. 3%), tissue transglutaminase-IgA (78% vs. 11%), and anti-endomysial-IgA (70% vs. 0%), were significantly more positive in ataxia/neuropathy patients with celiac disease versus those without enteropathy (P<0.001). Our findings suggest that the serological profile of gluten-sensitive ataxia/neuropathy without intestinal involvement lacks the recognition of deamidated gliadin and tissue transglutaminase epitopes.
Copyright © 2010. Published by Elsevier B.V.
PMID: 21056914
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For more detailed information about diagnostic testing see the Gluten File - Diagnostic Testing page.