Gluten ataxia

Gluten ataxia

Gluten ataxia is an autoimmune disease, which is triggered by the ingestion of gluten. Early diagnosis and treatment with a gluten-free diet can improve ataxia and prevent its progression. The effectiveness of the treatment depends on the elapsed time from the onset of the ataxia until diagnosis, because the death of neurons in the cerebellum as a result of gluten exposure is irreversible. It accounts for 40% of ataxias of unknown origin and 15% of all ataxias. Less than 10% of people with gluten ataxia present any gastrointestinal symptom and only about 40% have intestinal damage. It can co-occur with celiac disease and some maintain it is a presentation thereof. However, gluten ataxia is believed to be mediated by transglutaminase 6 antibodies, whereas celiac disease is associated with transglutaminase 2 antibodies. There is a continuum between presymptomatic ataxia and immune ataxias with clinical deficits. Gluten ataxia is classified as a primary auto-immune cerebellar ataxia (PACA).