NEUROMUSCULAR DISORDER AS A PRESENTING FEATURE OF CELIAC-DISEASE

Objectives-To describe the range of neuromuscular disorders which may be associated with cryptic coeliac disease. Methods-Nine patients were described with neuromuscular disorders associated with circulating an tigliadin antibodies, whose duodenal biopsies later confirmed the diag nosis of coeliac disease. Neurological symptoms antedated the diagnosi s of coeliac disease in all, and most had minimal or no gastrointestin al symptoms at the onset of the neuromuscular disorder. Results-Three patients had sensorimotor axonal peripheral neuropathy, one had axonal motor peripheral neuropathy, one had probable inclusion body myositis and axonal motor peripheral neuropathy, one had polymyositis and sens orimotor peripheral neuropathy, one had mononeuropathy multiplex, one had neuromyotonia, and one had polyneuropathy. Conclusion-A wide range of neuromuscular disease may be the presenting feature of coeliac dis ease. This represents the first report of inclusion body myositis and neuromyotonia associated with coeliac disease. Estimation of circulati ng antigliadin antibodies should be considered in all patients with ne uromuscular disease of otherwise obscure aetiology.