Hugh James Freeman*

Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, BC, Canada

*Corresponding Author: Hugh James Freeman, Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, BC, Canada.

Received: May 27, 2025; Published:June 12, 2025

Abstract

Focal white matter lesions in the central nervous system may occur in celiac disease, possibly due to a vascular cause or inflammatory demyelination likely reflecting a broad multi-system immune-mediated process. A 21 year old female developed a complex neurological syndrome, but had no intestinal symptoms or weight loss. Initial studies were abnormal with iron deficiency anemia and osteopenia with vitamin D3 deficiency. In spite of a slightly reduced serum immunoglobulin A level, screening tests for celiac disease were positive including raised serum antibodies to IgA tissue transglutaminase. Subsequent small intestinal mucosal biopsies showed features of untreated celiac disease. A gluten-free diet led to weight gain, resolution of abnormal serological tests and repeat small intestinal biopsies showed improvement. Unfortunately, neurological changes persisted. Adult celiac disease may occur more frequently than is currently appreciated in neurological disorders characterized by focal white matter lesions. Added long-term studies are needed to determine if a gluten-free diet can significantly improve accompanying neuropsychiatric changes.

Keywords: Celiac disease; Multiple Sclerosis; Demyelination

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Citation

Citation: Hugh James Freeman. “Central Nervous System White Matter Lesions in Biopsy-Defined Celiac Disease and Immunoglobulin A Deficiency".Acta Scientific Gastrointestinal Disorders 8.7 (2025): 12-15.

Copyright

Copyright: © 2025 Hugh James Freeman. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.