Camilo Vieira1, Izabele Jatobá2, Marília Matos3, Daniel Diniz-Santos4, Luciana R Silva4. 1. Departamento de Pediatria Neurológica, Universidade Federal da Bahia, SalvadorBA, Brasil. 2. Faculdade de Medicina, Universidade Federal da Bahia, SalvadorBA, Brasil. 3. Escola Bahiana de Medicina e Saúde Pública, SalvadorBA, Brasil. 4. Departamento de Gastroenterologia e Hepatologia Pediárica, Faculdade de Medicina, Universidade Federal da Bahia, SalvadorBA, Brasil.
Abstract
CONTEXT: Neurological symptoms have been well-documented in patients with celiac disease, nevertheless, the presumption of a greater prevalence of epilepsy in celiac patients remains controversial. OBJECTIVES: To determine the frequency of celiac disease in children and adolescents with idiopathic or cryptogenic epilepsy. METHODS: A cross-sectional study. One hundred pediatric patients with non-symptomatic epilepsy were followed-up at two public pediatric neurology clinics in Salvador, Bahia, Brazil. Screening for celiac disease was performed by serial measurements of IgA anti-transglutaminase and IgA anti-endomysium antibodies, followed by bowel biopsy in positive cases. HLA DQ02 and DQ08 were investigated in seropositive individuals, assessing the type of seizures, the number of antiepileptic drugs used and the presence gastrointestinal symptoms. RESULTS: Three (3.0%) patients tested anti-tTG-positive, two with normal duodenal mucosa (Marsh 0) and one with intraepithelial infiltrate (Marsh I). No villous atrophy of the duodenal mucosa (Marsh III) celiac disease was found. Two patients tested positive for HLA DQ02; none were DQ08 positive. CONCLUSION: The present study failed to prove the association between celiac disease and epilepsy.
CONTEXT: Neurological symptoms have been well-documented in patients with celiac disease, nevertheless, the presumption of a greater prevalence of epilepsy in celiac patients remains controversial. OBJECTIVES: To determine the frequency of celiac disease in children and adolescents with idiopathic or cryptogenic epilepsy. METHODS: A cross-sectional study. One hundred pediatric patients with non-symptomatic epilepsy were followed-up at two public pediatric neurology clinics in Salvador, Bahia, Brazil. Screening for celiac disease was performed by serial measurements of IgA anti-transglutaminase and IgA anti-endomysium antibodies, followed by bowel biopsy in positive cases. HLA DQ02 and DQ08 were investigated in seropositive individuals, assessing the type of seizures, the number of antiepileptic drugs used and the presence gastrointestinal symptoms. RESULTS: Three (3.0%) patients tested anti-tTG-positive, two with normal duodenal mucosa (Marsh 0) and one with intraepithelial infiltrate (Marsh I). No villous atrophy of the duodenal mucosa (Marsh III) celiac disease was found. Two patients tested positive for HLA DQ02; none were DQ08 positive. CONCLUSION: The present study failed to prove the association between celiac disease and epilepsy.