Anti-ganglioside antibodies in coeliac disease with neurological disorders

Background: Anti-ganglioside antibodies have been described in sera of coeliac patients with peripheral neuropathy and cerebellar ataxia. Aims: To investigate the correlation between anti-ganglioside antibodies and neurological involvement in coeliac disease before and after gluten-free diet. Patients and methods: Twenty-two untreated coeliac patients with neurological dysfunction and 30 untreated coeliacs without neurological dysfunction, 20 patients with neurological disorders, 50 autoimmune disease and 20 blood donors were tested for anti-GM1, anti-GD1b and anti-GQ1b IgG and IgM antibodies by enzyme-linked immunosorbent assay. Results: IgG antibodies to at least one of the three antigens tested were positive in 64% of coeliac patients with neurological symptoms compared to 30% of coeliacs without neurological dysfunction (P = 0.02), 50% of patients with neurological disorders (P = ns), 20% with autoimmune diseases (P = 0.003) and none of blood donors (P = 0.0001). A strict gluten-free diet determined anti-ganglioside antibody disappearance in about half of coeliacs. Conclusions: A significant correlation between anti-ganglioside antibodies and neurological disorders in patients with an underlying coeliac disease has been found. Anti-ganglioside antibodies may represent a new immunological marker to identify neurological impairment in patients with coeliac disease. © 2005 Editrice Gastroenterologica Italiana S.r.l.