Background and Aims Coeliac disease (CD) is an autoimmune disorder characterized by gastrointestinal symptoms, weight loss and anaemia. One of the commonest neurological manifestations of CD is painful peripheral neuropathy (PN). This occurs because of small fibre involvement (Aδ fibres and C fibres). Our aim was to establish the thermal pain thresholds in neurologically asymptomatic young CD patients compared to controls.
Methods Patients with biopsy proven CD and age and gender-matched healthy controls (1:1 ratio) participated in the study. All the participants were clinically and electrophysiologically evaluated. Thermal pain thresholds (warm and cold) were determined through quantitative sensory testing (QST). Patients with PN and/or comorbidities that are risk factors for the pathogenesis of PN (such as diabetes mellitus) were excluded.
Ethics Committee Approval.
Results 43 CD patients (79% females, mean age 35±9.4 years) and 43 controls were recruited. The two groups did not differ regarding height, BMI and the presence of chronic pain.
Pain thresholds in the warm (painful warm) and the cold (painful cold) temperature were lower in CD patients in both the upper and the lower limb compared to controls. There was a statistically significant difference between the two groups regarding the cold pain threshold(16.4°C±7.5°C και 12.1°C±9.0°C, p=0.023) and a trend for a statistically significant difference regarding the warm pain threshold(41.9°C±3.2°C και 43.3°C±3.3°C, p=0.067) in the upper limb.
Conclusions Asymptomatic young CD patients show abnormal pain thresholds compared to healthy controls. Cohort studies are needed to describe the natural history of neuropathic pain and PN development in these patients.