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Prevalence of serological markers for celiac disease (IgA and IgG class antigliadin antibodies and IgA class antiendomysium antibodies) in patients with autoimmune rheumatologic diseases in Belo Horizonte, MG, Brazil.
Arq Gastroenterol 2010 Jul-Sep; 47(3):250-6AG

Abstract

CONTEXT

Patients with autoimmune rheumatologic conditions and celiac disease tend to have a variety of autoantibodies, many of which have no clear pathogenic role. The literature contains frequent reports of celiac disease being more prevalent in patients with rheumatologic diseases, although this remains controversial.

OBJECTIVES

To investigate the prevalence of positive serum tests for celiac disease, particularly IgA and IgG antigliadin (AGA) antibodies and IgA antiendomysium antibodies (EmA) in patients with autoimmune rheumatologic diseases. A second aim was to correlate positive serum tests with prednisone and immunosuppressant medication.

METHODS

A total of 190 adults and pediatric patients with a variety of autoimmune rheumatologic diseases (systemic lupus erythematosus, rheumatoid arthritis, juvenile rheumatoid arthritis and spondyloarthrophathies) were evaluated and tested for IgA and IgG antigliadin-antibodies and IgA antiendomysium antibodies. Patients with positive serum tests underwent endoscopic duodenal biopsies for pathology studies.

RESULTS

There were four positive sera (2.1%) for AGA IgA, all of which tested negative for AGA IgG and EmA. Three sera (1.6%) tested positive for AGA IgG; all were negative for AGA IgA and EmA. The EmA test at a 1:2.5 serum dilution tested positive in 94 patients (49.5%); at a 1:5 serum dilution it was positive in 41 patients (21.6%). Eleven subjects tested positive for EmA at 1:40 dilution; and all of these tested negative for IgA tissue antitransglutaminase (tTG) antibodies. Nine of the 11 EmA-positive patients and all 7 patients with positive antigliadin antibodies tests underwent duodenal endoscopic biopsies, and no significant changes were demonstrated in their duodenal mucosa. A positive EmA was associated with elevated optical density AGA IgA readings; however, there was no relationship between positive EmA and AGA IgG optical density readings. Prednisone and immunosuppressant use were unrelated to AGA IgA optical density readings or AGA IgG readings. These drugs were associated with fewer positive EmA tests.

CONCLUSIONS

Positive AGAA, AGAG or EmA results are probably nonspecific for the presence of celiac disease among autoimmune rheumatologic disease patients. The intake of prednisone and immunosuprressant drugs seems to reduce the prevalence of IgA EmA, but it does not interfere with antigliadin antibodies tests.Further studies are required to estimate more accurately the prevalence of this disease in rheumatologic patients.

Authors+Show Affiliations

Department of Internal Medicine, Medical School of the Federal University of Minas Gerais, Belo Horizonte, MG, Brazil. vbkoehne@terra.com.br

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21140085

Citation

Koehne, Victor de Barros, et al. "Prevalence of Serological Markers for Celiac Disease (IgA and IgG Class Antigliadin Antibodies and IgA Class Antiendomysium Antibodies) in Patients With Autoimmune Rheumatologic Diseases in Belo Horizonte, MG, Brazil." Arquivos De Gastroenterologia, vol. 47, no. 3, 2010, pp. 250-6.
Koehne Vde B, Bahia M, Lanna CC, et al. Prevalence of serological markers for celiac disease (IgA and IgG class antigliadin antibodies and IgA class antiendomysium antibodies) in patients with autoimmune rheumatologic diseases in Belo Horizonte, MG, Brazil. Arq Gastroenterol. 2010;47(3):250-6.
Koehne, V. d. e. . B., Bahia, M., Lanna, C. C., Pinto, M. R., Bambirra, E. A., & Cunha, A. S. (2010). Prevalence of serological markers for celiac disease (IgA and IgG class antigliadin antibodies and IgA class antiendomysium antibodies) in patients with autoimmune rheumatologic diseases in Belo Horizonte, MG, Brazil. Arquivos De Gastroenterologia, 47(3), pp. 250-6.
Koehne Vde B, et al. Prevalence of Serological Markers for Celiac Disease (IgA and IgG Class Antigliadin Antibodies and IgA Class Antiendomysium Antibodies) in Patients With Autoimmune Rheumatologic Diseases in Belo Horizonte, MG, Brazil. Arq Gastroenterol. 2010;47(3):250-6. PubMed PMID: 21140085.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of serological markers for celiac disease (IgA and IgG class antigliadin antibodies and IgA class antiendomysium antibodies) in patients with autoimmune rheumatologic diseases in Belo Horizonte, MG, Brazil. AU - Koehne,Victor de Barros, AU - Bahia,Magda, AU - Lanna,Cristina Costa Duarte, AU - Pinto,Maria Raquel da Costa, AU - Bambirra,Eduardo Alves, AU - Cunha,Aloísio Sales da, PY - 2009/09/23/received PY - 2010/01/26/accepted PY - 2010/12/9/entrez PY - 2010/12/9/pubmed PY - 2011/10/6/medline SP - 250 EP - 6 JF - Arquivos de gastroenterologia JO - Arq Gastroenterol VL - 47 IS - 3 N2 - CONTEXT: Patients with autoimmune rheumatologic conditions and celiac disease tend to have a variety of autoantibodies, many of which have no clear pathogenic role. The literature contains frequent reports of celiac disease being more prevalent in patients with rheumatologic diseases, although this remains controversial. OBJECTIVES: To investigate the prevalence of positive serum tests for celiac disease, particularly IgA and IgG antigliadin (AGA) antibodies and IgA antiendomysium antibodies (EmA) in patients with autoimmune rheumatologic diseases. A second aim was to correlate positive serum tests with prednisone and immunosuppressant medication. METHODS: A total of 190 adults and pediatric patients with a variety of autoimmune rheumatologic diseases (systemic lupus erythematosus, rheumatoid arthritis, juvenile rheumatoid arthritis and spondyloarthrophathies) were evaluated and tested for IgA and IgG antigliadin-antibodies and IgA antiendomysium antibodies. Patients with positive serum tests underwent endoscopic duodenal biopsies for pathology studies. RESULTS: There were four positive sera (2.1%) for AGA IgA, all of which tested negative for AGA IgG and EmA. Three sera (1.6%) tested positive for AGA IgG; all were negative for AGA IgA and EmA. The EmA test at a 1:2.5 serum dilution tested positive in 94 patients (49.5%); at a 1:5 serum dilution it was positive in 41 patients (21.6%). Eleven subjects tested positive for EmA at 1:40 dilution; and all of these tested negative for IgA tissue antitransglutaminase (tTG) antibodies. Nine of the 11 EmA-positive patients and all 7 patients with positive antigliadin antibodies tests underwent duodenal endoscopic biopsies, and no significant changes were demonstrated in their duodenal mucosa. A positive EmA was associated with elevated optical density AGA IgA readings; however, there was no relationship between positive EmA and AGA IgG optical density readings. Prednisone and immunosuppressant use were unrelated to AGA IgA optical density readings or AGA IgG readings. These drugs were associated with fewer positive EmA tests. CONCLUSIONS: Positive AGAA, AGAG or EmA results are probably nonspecific for the presence of celiac disease among autoimmune rheumatologic disease patients. The intake of prednisone and immunosuprressant drugs seems to reduce the prevalence of IgA EmA, but it does not interfere with antigliadin antibodies tests.Further studies are required to estimate more accurately the prevalence of this disease in rheumatologic patients. SN - 1678-4219 UR - https://www.unboundmedicine.com/medline/citation/21140085/Prevalence_of_serological_markers_for_celiac_disease__IgA_and_IgG_class_antigliadin_antibodies_and_IgA_class_antiendomysium_antibodies__in_patients_with_autoimmune_rheumatologic_diseases_in_Belo_Horizonte_MG_Brazil_ L2 - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032010000300008&lng=en&nrm=iso&tlng=en DB - PRIME DP - Unbound Medicine ER -