Methods: Patients who have complex presentation involving multiple organs are difficult to diagnose. Non-infectious diseases that present with similar clinical patterns yet test negative to the known markers often arise due to certain change in environment or exposure. Such syndromes and diseases require careful study and call for new diagnostic modalities.
Results: Average length of symptoms prior to diagnosis was 5 years. Of 42 patients 34 were previously treated for 3 or more health issues. None of the patients were previously diagnosed with celiac disease, 7 patients underwent diagnostic endoscopy with biopsies. Most prevalent symptom (94%) was severe fatigue. Following symptoms were reported on questionnaire: sleep problems requiring medications, concentration/memory problem, constipation, depression, headaches/migraine, gastroesophageal reflux, nocturnal muscle spasms, abdominal distension, joint pain, rashes, and gum recession. Most common laboratory abnormality was positive ANA with homogenous pattern. All but 2 patients tested negative to tTG, gliadin and endomyseal antibodies. Of 17 patients screened for food allergy 94% were positive for 10+4 foods by skin test. 100 % of patients reported significant improvement at 1 mo interval with complete resolution of above listed clinical symptoms at 6 mo. Best recovery was achieved in patients when treatment regimen included supplemental therapy with CoQ10, fish oil and digestive enzymes based on papain. Of 25 patients attempted gluten introduction after complete clinical recovery 100% reported relapse of symptoms within 48 hours following gluten challenge.
Conclusions: We report the emergence of new clinical phenotype of non-celiac gluten induced systemic disease (GISD). Although recent publications specifying existence and possible explanation of this condition arise, mechanism is not understood. Thus further studies are needed to facilitate recognition, testing and understanding of GISD.