Migraines More Common in Celiac Disease (Which Could Still Have Normal Biopsy)

5.5 % of children with migraine were found to have elevated tTGA antibodies. They were considered Potential Celiac Disease [CD] despite normal duodenal biopsies. It is suggested “These patients might develop villous atrophy on repeated biopsies performed 1–4 years later and should be followed up closely.”

Increased risk for coeliac disease  in paediatric patients with migraine
F Alehan, F Ozçay, I Erol, O Canan, T Cemil
Cephalalgia, 2008, 28, 945–949

  • Apparently 6-10% of celiac cases develop neurological manifestations.
  • “20% of 75 diet-treated CD patients had unilateral and bilateral T2 hyperintensewhite-matter lesions in brain MRI” – these are seen in migraines as well.
  • An adult study found in celiac cases, 4.4% had migraines versus 0.4% in control group – this is a ten times incidence.

Comment –

  • A potentially treatable form of migraine. In subjects becoming disabled with headaches ahd more, a good look for celiac is warrented, and normal biopsies taken with suspicion.
  • I see a variety of chronic pain patients and find a high rate of atypical irritable bowel (wheat known to make some sick). Workup is sometimes unrevealing. One study found 10% cases with normal celaic antibodies will show these antibodies in their duodenal secretions. Another study found diarrhea – predominant irritable bowel, despite “normal” celiac antibodies levels, will normalize on a gluten free diet on 6 months followup. Noteworthy was the fact their “normal” celiac antibody levels were higher among responders and these levels dropped with gluten avoidance.

I am left with feeling that certain patients with known sensitivity to wheat, despite normal celiac workup, should be taken off gluten and watched to see if their antibody levels drop – an indication in my mind they were reacting to gluten.

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