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Subject:
From:
Don Wiss <[log in to unmask]>
Date:
Thu, 26 Oct 1995 12:41:52 -0400
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<<Disclaimer:  Verify this information before applying it to your situation.>>
 
This is listed as one of the possible celiac symptoms. In the CSA/USA flyer
on CD is lists peripheral neuropathy as numbness and tingling in fingers and
toes.
 
I started looking into it as there is a question on the autism list about
cold hands and feet in some gluten intolerant people. So I keyed this in
from the Merck Manual (16th ed):
 
Peripheral Neuropathy
 
...
 
Nutritional deficiency and metabolic disorders may result in polyneuropathy.
Deficiency of B vitamins is often the cause (eg, in alcoholism, beriberi,
pernicious anemia, isoniazid-induced pyridoxine deficiency, malabsorption
syndromes, and hyperemesis gravidarum). Polyneuropathy also occurs in
hypothyroidism, porphyria, sarcoidosis, amyloidosis, and uremia. Diabetes
mellitus causes several forms of neuropathy; sensorimotor distal
polyneuropathy (most common), multiple mononeuropathy, and focal
mononeuropathy (eg, of oculomotor or abducens cranial nerves).
 
...
 
Polyneuropathy is relatively symmetric; sensory, motor, and vasomotor fibers
often are involved simultaneously. (An acute, rapidly progressive form, the
Guillain-Barre syndrome, and hereditary neuropathies are discussed
separately below.) The most common form of polyneuropathy, seen with
metabolic disease (eg, diabetes mellitus, renal failure, malnutrition),
develops slowly, often over months or years; it frequently begins with
sensory abnormalities in the lower extremities. Abnormalities are often more
severe distally than proximally. Peripheral tingling, numbness, burning
pain, or deficiencies in joint proprioception and vibratory sensation often
are prominent. Pain is often worse at night and may be aggravated by
touching the affected area or by temperature changes. In severe cases,
objective signs of sensory loss, typically with stocking-and-glove
distribution, can be shown. The Achilles and other deep tendon reflexes are
diminished or absent. Painless ulcers on the digits or Charcot's joints may
be seen when sensory loss is profound. Sensory or proprioceptive deficits
may lead to gait abnormalities. Motor involvement results in distal muscle
weakness and atrophy.
 
The autonomic nervous system may be additionally or selectively involved,
leading to nocturnal diarrhea, bladder and bowel incontinence, impotence, or
postural hypotension. Vasomotor symptoms are variable. The skin may be paler
and drier than normal or there may be excess sweating and/or dusky
discoloration. Trophic changes are common in severe and prolonged cases;
they consist of smooth, shiny skin, pitted or ridged nails, and osteoporosis.
 
Uncommonly, an exclusively sensory polyneuropathy is seen, which begins with
peripheral pains and paresthesias and progresses centrally to a loss of all
forms of sensation. This occurs as a remote effect of carcinoma, especially
bronchogenic, after megadose intoxication with pyridoxine (B6), in
amyloidosis, hypothyroidism, myeloma, and uremia.
 
...

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