Celiac disease and ischemic stroke

Revue neurologique
B El MoutawakilI Slassi

Abstract

Neurological manifestations of celiac disease are various. An association with ischemic stroke is not common and has not been well documented. We report two cases. The first patient had experienced several transient ischemic strokes in the past 2 years and then had an acute ischemic stroke involving the territory of the right posterior cerebral artery. Investigations revealed celiac disease with no other recognizable etiology. The clinical course was marked by persistent visual aftereffects, but no new vascular event. The second patient had been followed since 1998 for celiac disease confirmed by pathology and serology tests. She was on a gluten-free diet. The patient had an ischemic stroke involving the territory of the left middle cerebral artery. Apart from a positive serology for celiac disease and iron deficiency anemia, the etiological work-up was negative. The mechanisms of vascular involvement in celiac disease are controversial. The most widely incriminated factor is autoimmune central nervous system vasculitis, in which tissue transglutaminase, the main auto-antigen contributing to maintaining the integrity of endothelium tissue, plays a major role. Other mechanisms are still debated, mainly vitamin deficiency. Being ...Continue Reading

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Citations

Apr 6, 2013·BMC Medicine·Aaron LernerYehuda Shoenfeld
Jul 19, 2012·World Journal of Gastroenterology : WJG·Elisa FabbriUmberto Volta
Jan 15, 2014·Journal des maladies vasculaires·N Ghannouchi JaafouraF Bahri
Apr 19, 2015·La Presse médicale·Wendy PoulinDominique Stephan
Sep 22, 2017·World Journal of Cardiology·Edward J CiaccioPeter H Green

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