Celiac Disease in Multiple Sclerosis: A Controversial Issue

Celiac disease is a common immune mediated disorder elicited by gluten that may manifest with neurological symptoms independent to gastrointestinal manifestations. The real prevalence of celiac disease in multiple sclerosis is still unclear because of limited population studies, different diagnostic assessment and possible non-celiac related response to gluten free diet. Recent studies have contributed to clarify genetic and immune overlap and discrepancy between the two conditions and are discussed in this review. Diagnostic delay of CD is frequently reported especially in extra intestinal symptoms. The recognition of celiac disease in patients with multiple sclerosis is critical to avoid malabsorption, to reduce morbidity and complications related to these disorders.