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COMMON FOOD SENSITIVITY LINKED TO PAINFUL PERIPHERAL NEUROPATHY
May 27, 2003
>From a press release
NEW YORK  -- The Neuropathy Association -- A link between Peripheral
Neuropathy and Celiac Disease was reported by physicians at the Weill
Medical College of Cornell University and New York Presbyterian Hospital
today, according to The Neuropathy Association.
Peripheral Neuropathy, which affects up to 20 million people in the U.S.,
can cause pain, numbness and weakness in the arms and legs and, when left
untreated, can progress to debilitation.
In an article published in today's Neurology, five percent of all patients
with neuropathy were found to also have celiac disease, which results from
an allergy to gluten in bread and other wheat products, and is estimated to
affect one out of every 150 people.  "Based on the diagnosis, we are now
able to treat a substantial number of patients with neuropathy who
previously could not be helped," said Dr. Russell Chin, the first author of
the paper.
In addition, patients with celiac disease tended to have a type of
neuropathy called "small fiber neuropathy" which often causes severe
burning, stinging, and electric-shock like pains, but is often misdiagnosed
as it is undetectable with routine tests used by neurologists to diagnose
neuropathy. Approximately 16% of all patients with small fiber neuropathy
were found to have celiac disease.  "Many of our patients were told that
there was nothing physically wrong with them, and were advised to seek
psychiatric care for presumed anxiety or depression," noted Dr. Norman
Latov, Medical and Scientific Director of The Neuropathy Association, and
senior author of the study.  "You too would be anxious and depressed if you
were in constant pain, and no-one believed you or offered to help."
Celiac disease is known to run in families, and in several of the cases,
other family members were affected.  Some were erroneously diagnosed with
Charcot-Marie-Tooth disease, an inherited form of neuropathy due to genetic
mutations.  "Not all familial cases of neuropathy are due to
Charcot-Marie-Tooth disease," noted Dr. Latov.  "Peripheral neuropathy can
also occur in association with other causes for neuropathy that run in
families, such as diabetes or autoimmunity, for example."
The article also notes that one third of the celiac neuropathy patients did
not have any gastrointestinal symptoms such as mal-absorption, abdominal
pain or diarrhea, which are associated with celiac disease.  "What many
people don't realize," notes Dr. Peter Green, Director of the Celiac
Disease
Center at the New York Presbyterian Hospital, and co-author of the paper,
"Is that 50% of adults with celiac disease have few or no gastrointestinal
symptoms, and present with other manifestations such as anemia, or as in
this case, peripheral neuropathy."  Treatment consists of eliminating
gluten or wheat containing foods in the diet.
At present, patients with neuropathy are not routinely tested for celiac
disease.  Based on the new study, however, patients and physicians should
be aware that anyone with unexplained neuropathy or pain should be tested for
celiac disease regardless of whether or not they have the classic
gastrointestinal symptoms.


Shelley Case, B. Sc., RD
Case Nutrition Consulting, www.glutenfreediet.ca
<http://www.glutenfreediet.ca>
Author: Gluten Free Diet: A Comprehensive Resource Guide
Co-Author: Celiac Section, Manual of Clinical Dietetics, American
Dietetic Association and Dietitians of Canada
Medical Advisory Board: Celiac Disease Foundation, Gluten Intolerance
Group, Canadian Celiac Association
Advisory Board: Gluten-Free Living Magazine and Living Without Magazine
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