Tag: gluten sensitivity

Markers of non-coeliac wheat sensitivity in patients with myalgic encephalomyelitis/chronic fatigue syndrome

We recently reported in Gut that non-coeliac wheat sensitivity (NCWS) is associated with a state of systemic immune activation in conjunction with a compromised intestinal epithelium.1 Patients with NCWS experience GI symptoms, most commonly including abdominal pain and bloating, as well as extraintestinal symptoms, among which fatigue, headache and cognitive difficulties feature prominently.1 2 A principal component analysis of the generated data from our study, including markers of antibody reactivity to wheat gluten, intestinal cell damage and systemic innate and adaptive immune responses to microbial components, found clustering of the patients and controls into discernible groups and demonstrated the potential utility of the identified biomarkers for identifying patients with NCWS.1

Extreme fatigue, in particular one that does not improve with rest, is a hallmark of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).3 Immune system abnormalities have been found to be associated with symptoms in a substantial number of patients with ME/CFS.4 5 Furthermore, many patients complain of GI symptoms of unknown aetiology.6–8 We considered whether a subset of patients with ME/CFS may exhibit serologic markers associated with NCWS, which might explain some of the corresponding symptoms. We screened serum samples from 131 patients with ME/CFS and 86 healthy controls (table 1), recruited as previously described,9 for the same markers as those in the above-mentioned study on NCWS.1 Questionnaires were used to assess GI symptoms within the past 6 months, including abdominal pain, bloating and nausea. Severity of individual symptoms was scored from 1 to 5 (1=absent; 2=mild; 3=moderate; 4=severe; 5=very severe), and a total score, based on the sum of individual symptom scores, was calculated for each subject.

Read full article HERE.

Source: Melanie Uhde, Alyssa C Indart, Xuechen B Yu, Sophie S Jang, Roberto De Giorgio, Peter H R Green, Umberto Volta, Suzanne D Vernon, Armin Alaedini. Markers of non-coeliac wheat sensitivity in patients with myalgic encephalomyelitis/chronic fatigue syndrome. http://dx.doi.org/10.1136/gutjnl-2018-316133

Chronic fatigue syndrome and non-celiac gluten sensitivity. Association or cause?

To the editor:

In their letter to the editor Response to: Fibromyalgia and chronic fatigue caused by non-celiac gluten sensitivity, Qanneta et al. pose a conceptual problem between the association of chronic fatigue syndrome (CFS) with non-celiac gluten sensitivity (SGNC) from the prevalent conception of considering chronic fatigue as a distinct disease. From this perspective, being chronic fatigue the central disease associated with other processes, they consider NCGS as a comorbid condition and not as an underlying cause.

You can read the rest of this letter here: http://www.reumatologiaclinica.org/en/chronic-fatigue-syndrome-non-celiac-gluten/articulo/S2173574314001762/

Comment on

 

Source: Isasi Zaragozá C. Chronic fatigue syndrome and non-celiac gluten sensitivity. Association or cause?Reumatol Clin. 2015 May-Jun;11(3):184. doi: 10.1016/j.reuma.2014.10.010. Epub 2014 Dec 10. http://www.reumatologiaclinica.org/en/chronic-fatigue-syndrome-non-celiac-gluten/articulo/S2173574314001762/ (Full article)

 

Response to: fibromyalgia and chronic fatigue syndrome caused by non-celiac gluten sensitivity

Dear Editor:

We have closely read the article published by Isasi et al.1 in Reumatologia Clínica presenting a case of fibromyalgia (FM) and chronic fatigue syndrome (CFS) caused by non-celiac sensitivity to gluten (NGCD). We would like to comment our experience with this attractive topic regarding patients with FM/CFS, which I hope will contribute to an improved knowledge of this association. The authors have reasonably ruled out celiac disease (CD) and have hypothesized that NGCD is the cause of FM and CFS in their patient; upon complete remission (CR) of symptoms, both digestive and musculoskeletal, with a gluten-free diet (GFD).

You can read the rest of this letter here: http://www.reumatologiaclinica.org/en/response-to-fibromyalgia-chronic-fatigue/articulo/S217357431400166X/

 

Source: Qanneta R, Fontova R, Castel A. Response to: fibromyalgia and chronic fatigue syndrome caused by non-celiac gluten sensitivity. Reumatol Clin. 2015 May-Jun;11(3):185. doi: 10.1016/j.reuma.2014.09.008. Epub 2014 Nov 7. http://www.reumatologiaclinica.org/en/response-to-fibromyalgia-chronic-fatigue/articulo/S217357431400166X/ (Full article)

Fibromyalgia and chronic fatigue syndrome caused by non-celiac gluten sensitivity

Dear Editor:

Sensitivity to gluten with negative celiac disease testing or non-celiac sensitivity to gluten is a recently recognized problem with clinical manifestations that are superimposed with those of fibromyalgia, chronic fatigue and irritable bowel syndrome.

We present the case of a 40-year-old woman who came to the clinic with a 7-year history of generalized pain and chronic fatigue. She had been diagnosed with fibromyalgia by several rheumatologists and complied with the 1990 American College or Rheumatology criteria. She also presented chronic fatigue syndrome criteria. She had concentration and memory problems, «foggy mind», and intermittent diarrhea. The severity of the affection led to limitation in her daily activities which limited her to bed rest in spite of several visits to specialists in rheumatology, gastroenterology and alternative medicine/homeopathy. In addition to the typical symptoms of fibromyalgia, chronic fatigue and intermittent diarrhea, she had oral ulcers, autoimmune hypothyroidism and a history of iron deficiency. She had undergone multiple studies with normal findings, including anti-transglutaminase IgA antibodies to rule out celiac disease.

We suspected sensitivity to gluten and more studies were performed. Laboratory studies showed iron deficiency and low vitamin D levels. On a screening test for anti-transglutaminase and anti-deaminated gliadin peptide antibodies, both IgG and IgA were negative. HLA typing showed the presence of DQ2 (DQA1*05 DQB1*02). Gastroscopy showed small erythematous lesions on the duodenal bulb. Duodenal biopsies showed normal villi structure and lymphocytic duodenitis with apical redistribution, 28 CD3 lymphocytes for every 100 enterocytes (stage I Marsh lesions). Urease testing for Helicobacter pylori was positive. Celiac disease was ruled out due to the absence of specific antibodies or intestinal villi atrophy, though we still suspected sensitivity to gluten. A gluten-free diet was recommended without treating the infection by Helicobacter pylori.

You can read the rest of this letter here: http://www.reumatologiaclinica.org/en/fibromyalgia-chronic-fatigue-syndrome-caused/articulo/S2173574314001403/

Comment in

 

Source: Isasi C, Tejerina E, Fernandez-Puga N, Serrano-Vela JI. Fibromyalgia and chronic fatigue syndrome caused by non-celiac gluten sensitivity. Reumatol Clin. 2015 Jan-Feb;11(1):56-7. doi: 10.1016/j.reuma.2014.06.005. Epub 2014 Jul 19. [Article in English, Spanish] http://www.reumatologiaclinica.org/es/linkresolver/fibromialgia-fatiga-cronica-causada-por/S1699258X14001326/ (Full article)