Celiac disease arthropathy and autoimmunity study. Issue 1 (19th December 2012)

• Record Type: Journal Article
• Authors: Iqbal, Tariq; Zaidi, Mukarram A; Wells, George A; Karsh, Jacob
• Is Part Of: Journal of gastroenterology and hepatology. Volume 28:Issue 1(2013:Jan.)
• Page Start: 99
• Page End: 105
• Publication Date: 2012-12-19
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/j.1440-1746.2012.07272.x
• Languages: English
• ISSNs: 0815-9319

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jgh7272-sec-0001" sec-type="section"> <title>Background and Aim</title> <p>To evaluate presence of sero‐negative spondyloarthritis (SpA) in celiac disease (CD) patients, and whether compliance with a gluten free diet (GFD) improved arthritis manifestations in these patients.</p> </sec> <sec id="jgh7272-sec-0002" sec-type="section"> <title>Methods</title> <p>We undertook a prospective, questionnaire based, cross‐sectional cohort study to evaluate the presence or absence of SpA simultaneously in both CD and non‐CD cohorts.</p> </sec> <sec id="jgh7272-sec-0003" sec-type="section"> <title>Results</title> <p>356/590 (60.3%) patients with CD participated in this study. 99% had diagnosis confirmed by a diagnostic test (79% small bowel biopsy, 19.8% blood test, 3.9% stool test). Approximately 131 (37%) cases of arthritis were reported in CD patients. Of the 6/356 CD patients with seronegative spondyloarthritides, four had sacroiliitis, two ankylosing spondylitis, and one psoriatic arthritis, compared to one ankylosing spondylitis and five psoriatic arthritis in non‐CD. Osteoarthritis (89 <italic>vs</italic> 59, <italic>P</italic> = 0.93) was the most common diagnosis reported by respondents. More CD patients with diarrhea (94%) and anemia (81%) improved on GFD, compared to arthritis symptoms (30%). Autoimmune thyroiditis (10.6% <italic>vs</italic> 0.4%), insulin dependent diabetes mellitus (IDDM) (2.2% <italic>vs</italic> 1.7%), systemic Lupus erythematosus (SLE) (1.1% <italic>vs</italic> 0), and psoriasis (12.9% <italic>vs</italic> 5.5%) occurred more frequently in CD patients. The prevalence of Crohn's disease, ulcerative colitis, Sjogren's syndrome, primary biliary cirrhosis, and primary sclerosing cholangitis was around 1% each. Univariate Logistic regression analysis showed ≤ high school education (odds ratio [OR] 2.01, <italic>P <</italic> 0.003), age ≥ 60 years (OR 4.13, <italic>P</italic> < 0.001), and osteoporosis (OR 2.78, <italic>P</italic> < 0.001) to be significantly associated with report of arthritis in CD patients.</p> </sec> <sec id="jgh7272-sec-0004" sec-type="section"> <title>Conclusion</title> <p>We did not find a high rate of SpA in CD patients. In contrast, increased rates of autoimmune thyroiditis, SLE, IDDM, and psoriasis were seen in CD.</p> </sec> </abstract>