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Celiac Disease Prevalence Is Increased in Primary Sjögren’s Syndrome and Diffuse Systemic Sclerosis: Lessons from a Large Multi-Center Study
Association of celiac disease (CD) with systemic autoimmune diseases (ADs) remains controversial. Awareness of CD in these patients is important to prevent complications, including lymphoproliferative disorders. We evaluated previously diagnosed CD prevalence in systemic lupus erythematosus (SLE), p...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517955/ https://www.ncbi.nlm.nih.gov/pubmed/31010199 http://dx.doi.org/10.3390/jcm8040540 |
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author | Bartoloni, Elena Bistoni, Onelia Alunno, Alessia Cavagna, Lorenzo Nalotto, Linda Baldini, Chiara Priori, Roberta Fischetti, Colomba Fredi, Micaela Quartuccio, Luca Carubbi, Francesco Montecucco, Carlomaurizio Doria, Andrea Mosca, Marta Valesini, Guido Franceschini, Franco De Vita, Salvatore Giacomelli, Roberto Mirabelli, Giulia Bini, Vittorio Gabrielli, Armando Catassi, Carlo Gerli, Roberto |
author_facet | Bartoloni, Elena Bistoni, Onelia Alunno, Alessia Cavagna, Lorenzo Nalotto, Linda Baldini, Chiara Priori, Roberta Fischetti, Colomba Fredi, Micaela Quartuccio, Luca Carubbi, Francesco Montecucco, Carlomaurizio Doria, Andrea Mosca, Marta Valesini, Guido Franceschini, Franco De Vita, Salvatore Giacomelli, Roberto Mirabelli, Giulia Bini, Vittorio Gabrielli, Armando Catassi, Carlo Gerli, Roberto |
author_sort | Bartoloni, Elena |
collection | PubMed |
description | Association of celiac disease (CD) with systemic autoimmune diseases (ADs) remains controversial. Awareness of CD in these patients is important to prevent complications, including lymphoproliferative disorders. We evaluated previously diagnosed CD prevalence in systemic lupus erythematosus (SLE), primary Sjögren’s syndrome (pSS) and systemic sclerosis (SSc) patients in comparison to 14,298 matched controls. All patients were screened for subclinical CD. Data from 1458 unselected consecutive SLE (580), pSS (354) and SSc (524) patients were collected. Previously biopsy-proven CD diagnosis and both CD- and AD-specific features were registered. All patients without previous CD were tested for IgA transglutaminase (TG). Anti-endomysium were tested in positive/borderline IgA TG. Duodenal biopsy was performed in IgA TG/endomysium+ to confirm CD. CD prevalence in AD was compared to that observed in 14,298 unselected sex- and age-matched adults who acted as controls. CD was more prevalent in pSS vs controls (6.78% vs 0.64%, p < 0.0001). A trend towards higher prevalence was observed in SLE (1.38%, p = 0.058) and SSc (1.34%, p = 0.096). Higher CD prevalence was observed in diffuse cutaneous SSc (4.5%, p ≤ 0.002 vs controls). Subclinical CD was found in two SLE patients and one pSS patient. CD diagnosis usually preceded that of AD. Primary SS and SSc–CD patients were younger at AD diagnosis in comparison to non-celiac patients. Autoimmune thyroiditis was associated with pSS and CD. CD prevalence is clearly increased in pSS and diffuse SSc in comparison to the general population. The association of CD with diffuse but not limited SSc may suggest different immunopathogenic mechanisms characterizing the two subsets. CD screening may be considered in pSS and diffuse SSc in young patients, particularly at the time of diagnosis. |
format | Online Article Text |
id | pubmed-6517955 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-65179552019-05-31 Celiac Disease Prevalence Is Increased in Primary Sjögren’s Syndrome and Diffuse Systemic Sclerosis: Lessons from a Large Multi-Center Study Bartoloni, Elena Bistoni, Onelia Alunno, Alessia Cavagna, Lorenzo Nalotto, Linda Baldini, Chiara Priori, Roberta Fischetti, Colomba Fredi, Micaela Quartuccio, Luca Carubbi, Francesco Montecucco, Carlomaurizio Doria, Andrea Mosca, Marta Valesini, Guido Franceschini, Franco De Vita, Salvatore Giacomelli, Roberto Mirabelli, Giulia Bini, Vittorio Gabrielli, Armando Catassi, Carlo Gerli, Roberto J Clin Med Article Association of celiac disease (CD) with systemic autoimmune diseases (ADs) remains controversial. Awareness of CD in these patients is important to prevent complications, including lymphoproliferative disorders. We evaluated previously diagnosed CD prevalence in systemic lupus erythematosus (SLE), primary Sjögren’s syndrome (pSS) and systemic sclerosis (SSc) patients in comparison to 14,298 matched controls. All patients were screened for subclinical CD. Data from 1458 unselected consecutive SLE (580), pSS (354) and SSc (524) patients were collected. Previously biopsy-proven CD diagnosis and both CD- and AD-specific features were registered. All patients without previous CD were tested for IgA transglutaminase (TG). Anti-endomysium were tested in positive/borderline IgA TG. Duodenal biopsy was performed in IgA TG/endomysium+ to confirm CD. CD prevalence in AD was compared to that observed in 14,298 unselected sex- and age-matched adults who acted as controls. CD was more prevalent in pSS vs controls (6.78% vs 0.64%, p < 0.0001). A trend towards higher prevalence was observed in SLE (1.38%, p = 0.058) and SSc (1.34%, p = 0.096). Higher CD prevalence was observed in diffuse cutaneous SSc (4.5%, p ≤ 0.002 vs controls). Subclinical CD was found in two SLE patients and one pSS patient. CD diagnosis usually preceded that of AD. Primary SS and SSc–CD patients were younger at AD diagnosis in comparison to non-celiac patients. Autoimmune thyroiditis was associated with pSS and CD. CD prevalence is clearly increased in pSS and diffuse SSc in comparison to the general population. The association of CD with diffuse but not limited SSc may suggest different immunopathogenic mechanisms characterizing the two subsets. CD screening may be considered in pSS and diffuse SSc in young patients, particularly at the time of diagnosis. MDPI 2019-04-19 /pmc/articles/PMC6517955/ /pubmed/31010199 http://dx.doi.org/10.3390/jcm8040540 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Bartoloni, Elena Bistoni, Onelia Alunno, Alessia Cavagna, Lorenzo Nalotto, Linda Baldini, Chiara Priori, Roberta Fischetti, Colomba Fredi, Micaela Quartuccio, Luca Carubbi, Francesco Montecucco, Carlomaurizio Doria, Andrea Mosca, Marta Valesini, Guido Franceschini, Franco De Vita, Salvatore Giacomelli, Roberto Mirabelli, Giulia Bini, Vittorio Gabrielli, Armando Catassi, Carlo Gerli, Roberto Celiac Disease Prevalence Is Increased in Primary Sjögren’s Syndrome and Diffuse Systemic Sclerosis: Lessons from a Large Multi-Center Study |
title | Celiac Disease Prevalence Is Increased in Primary Sjögren’s Syndrome and Diffuse Systemic Sclerosis: Lessons from a Large Multi-Center Study |
title_full | Celiac Disease Prevalence Is Increased in Primary Sjögren’s Syndrome and Diffuse Systemic Sclerosis: Lessons from a Large Multi-Center Study |
title_fullStr | Celiac Disease Prevalence Is Increased in Primary Sjögren’s Syndrome and Diffuse Systemic Sclerosis: Lessons from a Large Multi-Center Study |
title_full_unstemmed | Celiac Disease Prevalence Is Increased in Primary Sjögren’s Syndrome and Diffuse Systemic Sclerosis: Lessons from a Large Multi-Center Study |
title_short | Celiac Disease Prevalence Is Increased in Primary Sjögren’s Syndrome and Diffuse Systemic Sclerosis: Lessons from a Large Multi-Center Study |
title_sort | celiac disease prevalence is increased in primary sjögren’s syndrome and diffuse systemic sclerosis: lessons from a large multi-center study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517955/ https://www.ncbi.nlm.nih.gov/pubmed/31010199 http://dx.doi.org/10.3390/jcm8040540 |
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