Multiple Sclerosis and Celiac Disease
A recent study suggests there is an association between multiple sclerosis and celiac disease that involves nerve damage. Although on the surface the relationship between these two diseases may not be obvious, closer examination makes it clearer.
It’s well known that MS is associated with damage and destruction of the myelin, a protective sheath for the nerve cells. Previous research has shown that nerve damage (neuropathy) is part of celiac disease and an increased risk of multiple sclerosis and other nerve-related conditions.
New study of celiac disease
Researchers at Karolinska Institutet, Orebro University, and Columbia University College of Physicians and Surgeons worked together and explored the neuropathy/celiac relationship by evaluating 28,232 individuals with biopsy-verified celiac disease and 39,472 matched controls. Their findings were reported in the journal JAMA Neurology.
Celiac disease is a hereditary condition that affects approximately 1 percent of the population. It is characterized by an intolerance to a protein in wheat and other grains called gluten. This intolerance causes the body to attack the small intestine (an autoimmune response) and result in inflammation, constipation, diarrhea, pain, fatigue, and anemia.
Here’s what the authors found:
- Nearly 200 individuals with celiac disease were eventually diagnosed with neuropathy (0.7%) compared with 359 patients in the control group (0.3%)
- Overall, it was estimated that people with celiac disease were about 2.5 times more likely to be diagnosed with neuropathy than individuals who did not have the disease.
- This risk was similar between men and women
The authors noted that their findings suggested individuals with neuropathy or multiple sclerosis should be screened for celiac disease.
An association between the two diseases was further suggested in a recent letter in Immunology Letters, in which the author noted that “Patients with MS should be screened for CD [celiac disease] and vice versa the clinical management of adult patients with CD should take into account the risk of developing MS.” Researchers have also noted that autoimmune diseases (including celiac disease) frequently coexist with neuromyelitis optica, which also is associated with multiple sclerosis.
Celiac disease in multiple sclerosis
A team of Spanish researchers explored the prevalence of celiac disease in people with multiple sclerosis and their first-degree relatives. Seventy-two individuals with MS plus 126 of their first-degree relatives were part of the study, along with 123 healthy controls.
The researchers found an increased prevalence of celiac disease in 8 of the 72 (11.1%) patients with multiple sclerosis. In addition, 23 of the 126 (23%) first-degree relatives also had celiac disease.
Hopefully all of these findings will raise awareness of the possible association between celiac disease and multiple sclerosis. In turn, doctors and patients can use this understanding to improve management plans.
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Iver A et al. A review of the current literature and a guide to the early diagnosis of autoimmune disorders associated with neuromyelitis optica. Autoimmunity 2014 May; 47(3): 154-61
Mormile R. Multiple sclerosis and susceptibility to celiac disease: an osteopontin gene haplotypes affair? Immunology Letters 2015 Jan; 163(1): 132-33
Rodrigo L et al. Prevalence of celiac disease in multiple sclerosis. BMC Neurology 2011 Mar 7; 11:31
Thawani SP et al. Risk of neuropathy among 28,232 patients with biopsy-verified celiac disease. JAMA Neurology 2015 May 11. Online