Tourette Syndrome and Non-Coeliac Gluten Sensitivity. Clinical Remission with a Gluten-Free Diet: A Description Case

Abstract

Background: Tourette syndrome (TS) is a primary tic disorder, that reaches most commonly medical attention and monitoring, Its etiology remains unknow and there are scant information about the role of associated food intolerance to its presence. Methods: We analyze the case of a 13 y.o. female, with a long history of 10 years of tics and obsessivecompulsive disorder. She had a family history positive for celiac disease and we studied for her presence, determining serological markers (anti -tissue transglutaminase-2 (tTG), genetic markers of susceptibility (HLA-DQ2 and DQ8) and duodenal biopsies looking for the presence of villous atrophy and or lymphocytic enteritis. IgE specific to wheat, was also done. Results: The tTG was negative; HLA-DQ8 was positive and there was a moderate lymphocytic enteritis. IgE RAST test for wheat, was also negative. She was diagnosed of non-celiac gluten sensitivity (NCGS) and a glutenfree diet (GFD) was started. A great clinical improvement was observed in few months and after 2.5 years she remains well and completely asymtomatic of her neuro-psychiatric ailments. Conclusions: This clinical observation opens a new possibility of the existence a causal relationship between the presence of a TS in children with NCGS and by consequence the convenience to start a GFD in these patients. New studies will be needed in order to support this observation.