Arthritis and coeliac disease.
Open Access
- 1 September 1985
- journal article
- research article
- Published by BMJ in Annals Of The Rheumatic Diseases
- Vol. 44 (9), 592-598
- https://doi.org/10.1136/ard.44.9.592
Abstract
We report six patients with coeliac disease in whom arthritis was prominent at diagnosis and who improved with dietary therapy. Joint pain preceded diagnosis by up to three years in five patients and 15 years in one patient. Joints most commonly involved were lumbar spine, hips, and knees (four cases). In three cases there were no bowel symptoms. All were seronegative. X-rays were abnormal in two cases. HLA-type A1, B8, DR3 was present in five and B27 in two patients. Circulating immune complexes showed no consistent pattern before or after treatment. Coeliac disease was diagnosed in all patients by jejunal biopsy, and joint symptoms in all responded to a gluten-free diet. Gluten challenge (for up to three weeks) failed to provoke arthritis in three patients tested. In a separate study of 160 treated coeliac patients attending regular follow up no arthritis attributable to coeliac disease and no ankylosing spondylitis was identified, though in a control group of 100 patients with Crohn's disease the expected incidence of seronegative polyarthritis (23%) and ankylosing spondylitis (5%) was found (p less than 0.01). Arthritis appears to be a rare manifestation of coeliac disease. This relationship may provide important clues to the role of gastrointestinal antigens in rheumatic diseases.This publication has 24 references indexed in Scilit:
- Polymyositis and adult coeliac diseaseActa Neurologica Scandinavica, 1982
- Intestinal permeability in coeliac disease: the response to gluten withdrawal and single-dose gluten challenge.Gut, 1982
- Anti-gliadin antibodies and small intestinal mucosal damage in dermatitis herpetiformisBritish Journal of Dermatology, 1981
- New immunofluorescent blood test for gluten sensitivity.Archives of Disease in Childhood, 1981
- COELIAC DISEASE PRESENTING AS RECURRENT PERICARDITISThe Lancet, 1981
- Serum Folate Determinations in Tracing Adult CoeliacsScandinavian Journal of Gastroenterology, 1981
- EVIDENCE FOR COMPLEMENT-BINDING IMMUNE COMPLEXES IN ADULT CŒLIAC DISEASE, CROHN'S DISEASE, AND ULCERATIVE COLITISThe Lancet, 1973
- Immunoglobulins and dietary protein antibodies in childhood coeliac diseaseGut, 1970
- THE ARTHRITIS OF ULCERATIVE COLITISMedicine, 1959
- THE SURGICAL RELIEF OF INTESTINAL FOCI OF INFECTION IN CASES OF ARTHRITIS DEFORMANSAnnals of Surgery, 1922