IS THERE A CONNECTION BETWEEN CEREBRAL PALSY AND CELIAC DISEASE?

Objectives: Malnourishment can often be seen in children with severe neurological diseases including cerebral palsy (CP). Weight and height were sparsely measured and followed in these children even though it is well known that long periods of starvation can affect the neurodevelopment. Due to the spasticity in children with severe CP this group of children also have an increased need of nutrients. Apart from the spasticity several additional causes can worsen the nutritional status in these children, for instance disturbed swallowing, vomiting, gastro-oesophageal reflux with or without aspiration, delayed stomach emptying. The problem of not getting enough calories in these children have been increasingly recognised in the 1990s and more active efforts to meet this need have been done. Much is still unknown about nutritional status in these children. We don't know how the enteral uptake is working and what metabolic effects long periods of starvation might have. One observation we have seen in some children with severe CP and slow growth is an increased level of antibodies against gliadin. What this means is not clear. Does all children with cerebral palsy have a high risk of increased levels of celiac markers? Is it due to malnourishment? Do they have celiac disease? Our aims were therefore, to study laboratory markers for celiac disease in children with cerebral palsy.

Methods: 100 children with cerebral palsy, from two countys were screened for IgG and IgA antigliadin-antibodies, endomysial antibodies (EMA) and anti-tissue transglutaminase (tTG). The age range was from 1.5–23 years.

Results: 42% of the children had increased levels of antigliadin-antibodies (IgG and IgA) and anti-tTG. All were negative for EMA.

Conclusion: High levels of antigliadin-antibodies are seen in children with cerebral palsy. Small bowel biopsies will be done in all of these patients.