Objective: To evaluate the prevalence and clinical correlates of tremor in CD.

Background: Celiac disease (CD) is a systemic autoimmune disease, whose prevalence is of about 1% worldwide. Its neurological manifestations include ataxia, myoclonus, polyneuropathy, epilepsy and headache, with an overall prevalence of 5-36%. Tremor has been scarcely described.

Methods: An online inquest using an essential tremor screening scale (WHIGET, validated to Spanish) was published in the Argentinean Celiac Association website from June through July 2015. Demographic data, celiac antibodies and diet compliance were recorded. The same survey was also applied to an age and gender-matched control group comprised by non- blood relatives. Only CD patients with bowel biopsy confirmation (Marsh score ≥ III) were included. Data were analyzed using chi square test and ANOVA test accordingly.

Results: Fifteen hundred and twelve subjects completed the survey, of which 964 (64%) were included: 674 (69.9%) had CD and 290 (30.1%) were controls. Female gender was more frequent in the CD group than in controls (92% vs 81%, p<0.01). No significant differences were observed for age (p=0.5). Tremor prevalence was 27.7% in the CD group and 14.1 in the control group (p<0.001). Frequency of family history of tremor in CD patients with and without tremor was 24.6% and 19.9% (p=0.2), respectively; whereas in the control group it was 41.5% and 10.4% (p<0.001), respectively. Controls with tremor showed a higher frequency of family history of tremor when compared to CD patients with tremor (41.5% vs. 24.6%, p=0.03). No significant differences were found between CD patients with or without tremor for age, gender, celiac antibodies, gluten free-diet compliance and disease duration.

Conclusions: A higher prevalence of tremor in CD was found in comparison to controls. Frequency of family history of tremor was higher in controls with tremor, but not in CD patients with tremor, suggesting that tremor in CD might be possibly related to the disease process. Tremor in CD might be independent from demographics, celiac antibodies, gluten free-diet compliance or disease duration. Further confirmatory studies are warranted to assess real prevalence of tremor in CD patients and its clinical characteristics.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/is-tremor-related-to-celiac-disease/