{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:58:14Z","timestamp":1791907094269,"version":"4.3.4"},"reference-count":14,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T00:00:00Z","timestamp":1713484800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>We report on a group of patients with gluten sensitivity with and without coeliac disease presenting with unexplained sensory symptoms in the absence of structural pathology. Methods: The patients were selected from the gluten neurology clinic based at the Royal Hallamshire Hospital, Sheffield, UK, on the basis of sensory symptoms but normal neuroaxis imaging and peripheral nerve evaluation. Results: A total of 30 patients were identified with a mean age at presentation of 47 years. The prevalence of enteropathy was 78%. The sensory disturbance was characterised by tingling at 50%, numbness at 27%, pain at 20%, burning at 13% and \u201cbuzzing\u201d feeling at 7%. The distribution of the sensory symptoms included hands and feet in 27% of the patients, torso in 27%, legs only in 23%, face in 17% and arms only in 10%. For five patients, the sensory disturbance was migratory and affected different parts of the body at any given time. After the introduction of a gluten-free diet, 77% of patients noted significant improvement in their sensory symptoms. In one-third of the patients, there was a complete resolution of the sensory symptoms. Conclusion: Unexplained sensory symptoms can be seen in patients with gluten sensitivity and respond to strict adherence to a gluten-free diet.<\/jats:p>","DOI":"10.3390\/nu16081209","type":"journal-article","created":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T04:10:15Z","timestamp":1713499815000},"page":"1209","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Sensory Symptoms without Structural Pathology in Patients with Gluten Sensitivity"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2542-8954","authenticated-orcid":false,"given":"Marios","family":"Hadjivassiliou","sequence":"first","affiliation":[{"name":"Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Trust, Glossop Road, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Trott","sequence":"additional","affiliation":[{"name":"Department of Dietetics, Sheffield Teaching Hospitals NHS Trust, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6447-7639","authenticated-orcid":false,"given":"Nigel","family":"Hoggard","sequence":"additional","affiliation":[{"name":"Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield S10 2RX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Sanders","sequence":"additional","affiliation":[{"name":"Academic Department of Gastroenterology, Sheffield Teaching Hospitals NHS Trust, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/S1474-4422(09)70290-X","article-title":"Gluten sensitivity: From gut to brain","volume":"9","author":"Hadjivassiliou","year":"2010","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Caio, G., Volta, U., Sapone, A., Leffler, D.A., De Giorgio, R., Catassi, C., and Fasano, A. (2019). Celiac disease: A comprehensive current review. BMC Med., 17.","DOI":"10.1186\/s12916-019-1380-z"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1212\/WNL.0b013e3181f25ee0","article-title":"Sensory ganglionopathy due to gluten sensitivity","volume":"75","author":"Hadjivassiliou","year":"2010","journal-title":"Neurology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1001\/archneur.62.10.1574","article-title":"Small-fiber neuropathy\/neuronopathy associated with celiac disease: Skin biopsy findings","volume":"62","author":"Brannagan","year":"2005","journal-title":"Arch. Neurol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1002\/ana.21450","article-title":"Autoantibodies in gluten ataxia recognise a novel neuronal transglutaminase","volume":"64","author":"Hadjivassiliou","year":"2008","journal-title":"Ann. Neurol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1740","DOI":"10.1212\/WNL.0b013e3182919070","article-title":"Transglutaminase 6 antibodies in the diagnosis of gluten ataxia","volume":"80","author":"Hadjivassiliou","year":"2013","journal-title":"Neurology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2678","DOI":"10.1016\/j.cgh.2019.03.014","article-title":"Neurologic deficits in patients with newly diagnosed celiac disease are frequent and linked with autoimmunity to transglutaminase 6","volume":"17","author":"Hadjivassiliou","year":"2019","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1001\/jamaneurol.2015.0475","article-title":"Risk of neuropathy among 28232 patients with biopsy-verified celiac disease","volume":"72","author":"Thawani","year":"2015","journal-title":"JAMA Neurol."},{"key":"ref_9","unstructured":"Wartenberg, R. (1958). Migrant Sensory Neuritis, a Clinical Study with Review of Literature, Oxford University Press."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1146\/annurev-pathmechdis-031521-032634","article-title":"The immunobiology and pathogenesis of celiac disease","volume":"18","author":"Iversen","year":"2023","journal-title":"Annu. Rev. Pathol. Mech. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1038\/nm0797-797","article-title":"Identification of tissue transglutaminase as the autoantigen of celiac disease","volume":"3","author":"Dieterich","year":"1997","journal-title":"Nat. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1084\/jem.20011299","article-title":"Epidermal transglutaminase (TGase3) is the autoantigen of Dermatitis Herpetiformis","volume":"195","author":"Merkl","year":"2002","journal-title":"J. Exp. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1007\/s00726-010-0554-y","article-title":"Gliadin T-cell epitope targeting by TG3 and TG6: Implications for dermatitis herpetiformis and gluten ataxia","volume":"39","author":"Stamnaes","year":"2010","journal-title":"Amino Acids"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1259887","DOI":"10.3389\/fneur.2023.1259887","article-title":"Sensory nerve action potential in patients with functional neurological disorders with sensory manifestations","volume":"14","author":"Morimoto","year":"2023","journal-title":"Front. Neurol."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/8\/1209\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:30:37Z","timestamp":1760106637000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/8\/1209"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,19]]},"references-count":14,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["nu16081209"],"URL":"https:\/\/doi.org\/10.3390\/nu16081209","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,19]]}}}