More MS news articles for Aug 2001

Brain White-Matter Lesions Are an Extraintestinal Manifestation of Celiac Disease

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WESTPORT, CT (Reuters Health) Aug 09 - Children with celiac disease often have brain white-matter lesions, Dr. Matthias Kieslich and colleagues from Johann Wolfgang Goethe University in Frankfurt, Germany, report in the August issue of Pediatrics.

The prognostic significance of these lesions is unclear and needs to be determined, according to the researchers.

In their examination of 75 diet-treated children with celiac disease, Dr. Kieslich said he and his colleagues expected to find brain calcifications. "But computed tomography did not reveal any cerebral calcifications, he told Reuters Health. "Instead, we were surprised that magnetic resonance imaging detected unilateral and bilateral T2-hyperintensive periventricular lesions in 15 patients."

"Focal white-matter lesions seem to be more typical for pediatric celiac disease than cerebral calcifications," he added.

These lesions occur without specific neurologic symptoms and seem to be independent of dietary compliance or length of gluten exposure time, according to the results of the prospective study. The lesions may have an ischemic origin, Dr. Kieslich said, arising from vasculitis or caused by inflammatory demyelination.

"There have been reports of brain white-matter lesions as an extraintestinal manifestation of Crohn disease and ulcerative colitis, but not in celiac disease," Dr. Kieslich said. Celiac disease, he continued, "should be considered in the differential diagnosis of children with unclear white-matter lesions even without intestinal symptoms."

Pediatrics 2001;108:e21. [Full text of article]

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