Subclinical Axonal Neuropathy at Onset of Celiac Disease in a Pediatric Cohort

Celiac disease (CD) is a multifactorial enteropathy induced by the ingestion of gluten in susceptible individuals. It’s widely accepted that CD is an immune-mediated enteropathy and clinical manifestations range from typical signs or symptoms of intestinal malabsorption to atypical cases with scarce gastro-intestinal symptoms and extra-intestinal manifestations. Several neurological syndromes have been associated to CD and include epilepsy, myoclonus, ataxia, internuclear ophtalmoplegia, multifocal leukoencephalopathy and peripheral neuropathies of axonal and demyelinating type. In this small case series, electromyography and the study of nerve conduction were performed in 10 young children at first diagnosis of CD without any neurologic sign or symptom. The presence of mild axonal polyneuropathy was revealed in 6 patients, especially involving motor fibers and showing great affinity to peroneal fibers.