Research Article
Year 2024,
Volume: 3 Issue: 1, 300 - 305, 29.03.2024
Abstract
References
- 1. Singh P, Arora A, Strand TA, et al. Global prevalence of celiac disease: systematic review and meta-analysis. Clinical gastroenterology and hepatology 2018;16:823-36. e2.
- 2. Vivas S, De Morales JMR, Fernandez M, et al. Age-related clinical, serological, and histopathological features of celiac disease. Official journal of the American College of Gastroenterology| ACG 2008;103:2360-5.
- 3. Calim A, Kanat E, Mazi EE, Oygen S, Karabay U, Borlu F. Evaluation of In-patients with Iron Deficiency Anemia in terms of Etiology. The Medical Bulletin of Sisli Etfal Hospital 2020;54:428.
- 4. Kamycheva E, Goto T, Camargo C. Celiac disease is associated with reduced bone mineral density and increased FRAX scores in the US National Health and Nutrition Examination Survey. Osteoporosis International 2017;28:781-90.
- 5. Ludvigsson JF, Leffler DA, Bai JC, et al. The Oslo definitions for coeliac disease and related terms. Gut 2013;62:43-52.
- 6. Dima A, Jurcut C, Jinga M. Rheumatologic manifestations in celiac disease: what should we remember? Romanian Journal of Internal Medicine 2019;57:3-5.
- 7. Molberg Ø, Sollid LM. A gut feeling for joint inflammation–using coeliac disease to understand rheumatoid arthritis. Trends in immunology 2006;27:188-94.
- 8. Tovoli F, Giampaolo L, Caio G, et al. Fibromyalgia and coeliac disease: a media hype or an emerging clinical problem. Clin Exp Rheumatol 2013;31:S50-2.
- 9. Bibbò S, Pes GM, Usai-Satta P, et al. ChroRheumatismnic autoimmune disorders are increased in coeliac disease: a case–control study. Medicine 2017;96.
- 10. Demirezer Bolat A, Akın FE, Tahtacı M, et al. Risk factors for polyautoimmunity among patients with celiac disease: a cross-sectional survey. Digestion 2015;92:185-91.
- 11. Jericho H, Sansotta N, Guandalini S. Extraintestinal manifestations of celiac disease: effectiveness of the gluten-free diet. Journal of pediatric gastroenterology and nutrition 2017;65:75-9.
- 12. Vereckei E, Mester Á, Hodinka L, Temesvári P, Kiss E, Poór G. Back pain and sacroiliitis in long-standing adult celiac disease: a cross-sectional and follow-up study. Rheumatology international 2010;30:455-60.
- 13. Dos Santos S, Lioté F. Osteoarticular manifestations of celiac disease and non-celiac gluten hypersensitivity. Joint Bone Spine 2017;84:263-6.
- 14. Shor DB-A, Orbach H, Boaz M, et al. Gastrointestinal-associated autoantibodies in different autoimmune diseases. American journal of clinical and experimental immunology 2012;1:49.
- 15. Francis J, Carty JE, Scott BB. The prevalence of coeliac disease in rheumatoid arthritis. European journal of gastroenterology & hepatology 2002;14:1355-6.
- 16. Ludvigsson JF, Murray JA. Epidemiology of celiac disease. Gastroenterology Clinics 2019;48:1-18.
- 17. Fasano A, Berti I, Gerarduzzi T, et al. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Archives of internal medicine 2003;163:286-92.
- 18. Volta U, De Franceschi L, Lari F, Molinaro N, Zoli M, Bianchi FB. Coeliac disease hidden by cryptogenic hypertransaminasaemia. The Lancet 1998;352:26-9.
- 19. Lauret E, Rodrigo L. Celiac disease and autoimmune-associated conditions. BioMed research international 2013;2013.
- 20. Lundin KE, Wijmenga C. Coeliac disease and autoimmune disease—genetic overlap and screening. Nature reviews Gastroenterology & hepatology 2015;12:507-15.
- 21. Schalk K, Lexhaller B, Koehler P, Scherf KA. Isolation and characterization of gluten protein types from wheat, rye, barley and oats for use as reference materials. PloS one 2017;12:e0172819.
- 22. Antvorskov JC, Josefsen K, Engkilde K, Funda DP, Buschard K. Dietary gluten and the development of type 1 diabetes. Diabetologia 2014;57:1770-80.
- 23. Geylani Güleç S, Urgancı N, Gül F, Emecen M, Erdem E. Evaluation of tissue transglutaminase IgA antibody in diagnosis and following up of celiac disease in children. The Medical Bulletin of Sisli Etfal Hospital;45:119-23.
- 24. Dieterich W, Ehnis T, Bauer M, et al. Identification of tissue transglutaminase as the autoantigen of celiac disease. Nature medicine 1997;3:797-801.
- 25. Lerner A, Matthias T. Rheumatoid arthritis–celiac disease relationship: Joints get that gut feeling. Autoimmunity reviews 2015;14:1038-47.
- 26. Fayyaz B, Gunawan F, Rehman HJ. ‘Preclinical’rheumatoid arthritis in patients with celiac disease: A cross-sectional study. Journal of Community Hospital Internal Medicine Perspectives 2019;9:86-91.
- 27. Elhami E, Zakeri Z, Sadeghi A, Rostami-Nejad M, Volta U, Zali MR. Prevalence of celiac disease in Iranian patients with rheumatologic disorders. Gastroenterology and Hepatology From bed to Bench 2018;11:239.
- 28. Neuhausen SL, Steele L, Ryan S, et al. Co-occurrence of celiac disease and other autoimmune diseases in celiacs and their first-degree relatives. Journal of autoimmunity 2008;31:160-5.
- 29. Ramos-Casals M, Brito-Zerón P, Bombardieri S, et al. EULAR recommendations for the management of Sjögren’s syndrome with topical and systemic therapies. Annals of the rheumatic diseases 2020;79:3-18.
- 30. Leffler DA, Green PH, Fasano A. Extraintestinal manifestations of coeliac disease. Nature Reviews Gastroenterology & Hepatology 2015;12:561-71.
- 31. Therrien A, Kelly CP, Silvester JA. Celiac disease: extraintestinal manifestations and associated conditions. Journal of clinical gastroenterology 2020;54:8.
- 32. Daron C, Soubrier M, Mathieu S. Occurrence of rheumatic symptoms in celiac disease: A meta-analysis: Comment on the article” Osteoarticular manifestations of celiac disease and non-celiac gluten hypersensitivity” by Dos Santos and Lioté. Joint Bone Spine 2016. Joint Bone Spine 2017;84:645-6.
- 33. Evangelatos G, Kouna K, Iliopoulos A, Fragoulis GE. Musculoskeletal Complications of Celiac Disease: A Case-Based Review. Mediterranean Journal of Rheumatology 2023;34:86.
- 34. Iltanen S, Collin P, Korpela M, et al. Celiac disease and markers of celiac disease latency in patients with primary Sjögren’s syndrome. The American journal of gastroenterology 1999;94:1042-6.
- 35. Bartoloni E, Bistoni O, Alunno A, et al. Celiac disease prevalence is increased in primary sjögren’s syndrome and diffuse systemic sclerosis: lessons from a large multi-center study. Journal of clinical medicine 2019;8:540.
A disease to consider in the differential diagnosis of lower back pain: celiac disease and associated autoimmune disorders
Abstract
Introductıon: Celiac disease (CD) is an autoimmune disease caused by gluten ingestion in genetically susceptible individuals. Although gastrointestinal system symptoms are common, extraintestinal symptoms may be seen during the disease course. Due to similar genetic features and pathogenetic pathways for autoimmunity, increasing rheumatological diseases have been reported in CD in recent years. In this study, we aimed to evaluate patients with CD in terms of musculoskeletal symptomatology and presence of rheumatic disease and autoantibody positivity.
Methods: The study was designed as a cross-sectional, retrospective cohort study. Between January 2020-2022, 65 patients with CD who were followed-up in the gastroenterology clinic of our hospital and consulted to the rheumatology outpatient clinic for any reason were included in the study. Medical records were reviewed, laboratory and imaging results were recorded.
Results: Admission to the rheumatology clinic, the most common symptoms were inflammatory back pain(IBP) (43.1%) followed by xerophthalmia (15.4%). None of the patients with IBP had radiographically active sacroiliitis. In total, concomitant rheumatological diseases were 6 (9.2%): 2 patients (3.1%) had Sjögren’s syndrome and one undifferentiated connective tissue disease, systemic lupus erythematosus, psoriatic arthritis and familial Mediterranean fever. Except for the CD autoantibodies, the frequency of anti-nuclear antibodies (ANA) was 38%, and the most common extractable nuclear antigen (ENA) patterns were DFS-70 and SSA.
Conclusion: Although the most common symptom is IBP, the absence of radiographic findings of spondyloarthritis in CD patients suggests these to be a non-rheumatological cause associated with CD. On the other hand, CD patients with xerophthalmia and/or ANA positivity may need to be evaluated for connective tissue diseases, especially SjS.
Keywords
References
- 1. Singh P, Arora A, Strand TA, et al. Global prevalence of celiac disease: systematic review and meta-analysis. Clinical gastroenterology and hepatology 2018;16:823-36. e2.
- 2. Vivas S, De Morales JMR, Fernandez M, et al. Age-related clinical, serological, and histopathological features of celiac disease. Official journal of the American College of Gastroenterology| ACG 2008;103:2360-5.
- 3. Calim A, Kanat E, Mazi EE, Oygen S, Karabay U, Borlu F. Evaluation of In-patients with Iron Deficiency Anemia in terms of Etiology. The Medical Bulletin of Sisli Etfal Hospital 2020;54:428.
- 4. Kamycheva E, Goto T, Camargo C. Celiac disease is associated with reduced bone mineral density and increased FRAX scores in the US National Health and Nutrition Examination Survey. Osteoporosis International 2017;28:781-90.
- 5. Ludvigsson JF, Leffler DA, Bai JC, et al. The Oslo definitions for coeliac disease and related terms. Gut 2013;62:43-52.
- 6. Dima A, Jurcut C, Jinga M. Rheumatologic manifestations in celiac disease: what should we remember? Romanian Journal of Internal Medicine 2019;57:3-5.
- 7. Molberg Ø, Sollid LM. A gut feeling for joint inflammation–using coeliac disease to understand rheumatoid arthritis. Trends in immunology 2006;27:188-94.
- 8. Tovoli F, Giampaolo L, Caio G, et al. Fibromyalgia and coeliac disease: a media hype or an emerging clinical problem. Clin Exp Rheumatol 2013;31:S50-2.
- 9. Bibbò S, Pes GM, Usai-Satta P, et al. ChroRheumatismnic autoimmune disorders are increased in coeliac disease: a case–control study. Medicine 2017;96.
- 10. Demirezer Bolat A, Akın FE, Tahtacı M, et al. Risk factors for polyautoimmunity among patients with celiac disease: a cross-sectional survey. Digestion 2015;92:185-91.
- 11. Jericho H, Sansotta N, Guandalini S. Extraintestinal manifestations of celiac disease: effectiveness of the gluten-free diet. Journal of pediatric gastroenterology and nutrition 2017;65:75-9.
- 12. Vereckei E, Mester Á, Hodinka L, Temesvári P, Kiss E, Poór G. Back pain and sacroiliitis in long-standing adult celiac disease: a cross-sectional and follow-up study. Rheumatology international 2010;30:455-60.
- 13. Dos Santos S, Lioté F. Osteoarticular manifestations of celiac disease and non-celiac gluten hypersensitivity. Joint Bone Spine 2017;84:263-6.
- 14. Shor DB-A, Orbach H, Boaz M, et al. Gastrointestinal-associated autoantibodies in different autoimmune diseases. American journal of clinical and experimental immunology 2012;1:49.
- 15. Francis J, Carty JE, Scott BB. The prevalence of coeliac disease in rheumatoid arthritis. European journal of gastroenterology & hepatology 2002;14:1355-6.
- 16. Ludvigsson JF, Murray JA. Epidemiology of celiac disease. Gastroenterology Clinics 2019;48:1-18.
- 17. Fasano A, Berti I, Gerarduzzi T, et al. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Archives of internal medicine 2003;163:286-92.
- 18. Volta U, De Franceschi L, Lari F, Molinaro N, Zoli M, Bianchi FB. Coeliac disease hidden by cryptogenic hypertransaminasaemia. The Lancet 1998;352:26-9.
- 19. Lauret E, Rodrigo L. Celiac disease and autoimmune-associated conditions. BioMed research international 2013;2013.
- 20. Lundin KE, Wijmenga C. Coeliac disease and autoimmune disease—genetic overlap and screening. Nature reviews Gastroenterology & hepatology 2015;12:507-15.
- 21. Schalk K, Lexhaller B, Koehler P, Scherf KA. Isolation and characterization of gluten protein types from wheat, rye, barley and oats for use as reference materials. PloS one 2017;12:e0172819.
- 22. Antvorskov JC, Josefsen K, Engkilde K, Funda DP, Buschard K. Dietary gluten and the development of type 1 diabetes. Diabetologia 2014;57:1770-80.
- 23. Geylani Güleç S, Urgancı N, Gül F, Emecen M, Erdem E. Evaluation of tissue transglutaminase IgA antibody in diagnosis and following up of celiac disease in children. The Medical Bulletin of Sisli Etfal Hospital;45:119-23.
- 24. Dieterich W, Ehnis T, Bauer M, et al. Identification of tissue transglutaminase as the autoantigen of celiac disease. Nature medicine 1997;3:797-801.
- 25. Lerner A, Matthias T. Rheumatoid arthritis–celiac disease relationship: Joints get that gut feeling. Autoimmunity reviews 2015;14:1038-47.
- 26. Fayyaz B, Gunawan F, Rehman HJ. ‘Preclinical’rheumatoid arthritis in patients with celiac disease: A cross-sectional study. Journal of Community Hospital Internal Medicine Perspectives 2019;9:86-91.
- 27. Elhami E, Zakeri Z, Sadeghi A, Rostami-Nejad M, Volta U, Zali MR. Prevalence of celiac disease in Iranian patients with rheumatologic disorders. Gastroenterology and Hepatology From bed to Bench 2018;11:239.
- 28. Neuhausen SL, Steele L, Ryan S, et al. Co-occurrence of celiac disease and other autoimmune diseases in celiacs and their first-degree relatives. Journal of autoimmunity 2008;31:160-5.
- 29. Ramos-Casals M, Brito-Zerón P, Bombardieri S, et al. EULAR recommendations for the management of Sjögren’s syndrome with topical and systemic therapies. Annals of the rheumatic diseases 2020;79:3-18.
- 30. Leffler DA, Green PH, Fasano A. Extraintestinal manifestations of coeliac disease. Nature Reviews Gastroenterology & Hepatology 2015;12:561-71.
- 31. Therrien A, Kelly CP, Silvester JA. Celiac disease: extraintestinal manifestations and associated conditions. Journal of clinical gastroenterology 2020;54:8.
- 32. Daron C, Soubrier M, Mathieu S. Occurrence of rheumatic symptoms in celiac disease: A meta-analysis: Comment on the article” Osteoarticular manifestations of celiac disease and non-celiac gluten hypersensitivity” by Dos Santos and Lioté. Joint Bone Spine 2016. Joint Bone Spine 2017;84:645-6.
- 33. Evangelatos G, Kouna K, Iliopoulos A, Fragoulis GE. Musculoskeletal Complications of Celiac Disease: A Case-Based Review. Mediterranean Journal of Rheumatology 2023;34:86.
- 34. Iltanen S, Collin P, Korpela M, et al. Celiac disease and markers of celiac disease latency in patients with primary Sjögren’s syndrome. The American journal of gastroenterology 1999;94:1042-6.
- 35. Bartoloni E, Bistoni O, Alunno A, et al. Celiac disease prevalence is increased in primary sjögren’s syndrome and diffuse systemic sclerosis: lessons from a large multi-center study. Journal of clinical medicine 2019;8:540.
There are 35 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Traditional, Complementary and Integrative Medicine (Other) |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | March 29, 2024 |
| Submission Date | January 29, 2024 |
| Acceptance Date | March 15, 2024 |
| Published in Issue | Year 2024 Volume: 3 Issue: 1 |
