Original articleLow Prevalence of Neurologic and Psychiatric Manifestations in Children with Gluten Sensitivity
Section snippets
Subject Selection
The GS clinic at the Department of Pediatrics, University of Catania is the referral center for the town of Catania (which has 336,000 inhabitants, 98,000 of whom are children) and for patients with GS or GSE and their families who live in the province of Catania in eastern Sicily (which has an overall population of 967,000 of the 5.6 million inhabitants of Sicily), as well as others from other eastern (Siracusa and Ragusa) and central (Enna and Caltanissetta) provinces of Sicily.
Between
Serologic Testing
The results of the 3 methodologically different autoantibody tests are summarized in Table I. Four of the 835 children with GS were negative on all tests and were found to have IgA deficiency. All of the 835 children with GS had positive gut biopsies. The predictive values of the antibody assays for a positive duodenal biopsy were 90.4% for AGA, 99.5% for EMA, and 99.5% for anti-tTG antibody.
Neurologic Screening in Children with GS
Of the 835 children with GS, 15 (1.79%) with previously diagnosed GSA had neurologic problems (Table II),
Discussion
In this population-based, matched-reference, prospective cohort study, we found that the childhood GS population had a very low risk (1.79%) of developing neurologic disease; however, the frequency of neurologic disease was slightly higher in the GS population than in controls (P = .041). Notably, all of the typically associated neurologic manifestations of GS occurred at low frequency, similar to that in the general population. No children with GS exhibited cerebellar dysfunction, and none of
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Drs Ruggieri, Polizzi, and Pavone wrote the first draft of the manuscript. Drs Incorpora and Parano collaborated on recruitment and analysis of neurologic patients. Dr Spina collaborated on the diagnostic workup, follow-up, and analysis of gluten-sensitive patients. All of the authors collaborated on the second and subsequent drafts of the manuscript. No honorarium, grant, or other form of payment was given to anyone to produce this manuscript.