Objective: to report a case of celiac disease (CD) revealed by an ataxic gait in a young woman.

Background: CD is an immune-mediated gastrointestinal disorder driven by innate and adaptive immune responses to gluten. Patients with CD are at an increased risk of several neurological manifestations, most commonly gluten ataxia. However, its occurrence at presentation, before CD’s diagnosis, can result in lengthened diagnostic delay.

Method: a case report

Results: a 23 years-old woman, from non-consanguineous parents, presented to our department with a history of gradually progressive ataxia. She had no personal or familial history of medical disease. On examination, she had an ataxic gait with a bilateral cerebellar signs over lower limbs. There was no motor or sensory deficit and deep tendon reflexes were normal. All the cranial nerves and ocular movements were intact and there were no nystagmus. Therefore, the patient complained of diarrhea over the last few months. Brain MRI didn’t show any cerebellar abnormalities. An extensive blood examination performed, including vitamin E, B12 levels and thyroid hormones, was normal. Workup for infective and auto-immune diseases was negative. Blood test was positive for anti-gliadin antibody, anti-transglutaminase antibody and anti-endomysium antibody; and duodenal biopsy showed a villous atrophy. The diagnosis of CD was eventually confirmed and an improvement of her ataxic gait was noted within few months after the initiation of an effective gluten-free diet.

Conclusion: we highlight, through this case, the need for physicians to consider treatable disease, such as CD, in patients with ataxia of unknown etiology, as symptoms can resolve after adherence to a gluten-free diet.

« Back to MDS Virtual Congress 2021

MDS Abstracts - https://www.mdsabstracts.org/abstract/gluten-induced-ataxia-a-misdiagnosed-cause-of-sporadic-ataxia-a-case-report/