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Prevalence and clinical relevance of enteropathy associated with systemic autoimmune diseases.
Dig Liver Dis. 2012 Aug; 44(8):636-42.DL

Abstract

OBJECTIVE

To assess whether systemic autoimmune diseases are a risk group for coeliac disease and if there is a systemic autoimmune diseases-associated enteropathy.

METHODS

183 patients with systemic autoimmune diseases were included. Duodenal biopsy was carried out on patients with positive coeliac genetics (HLA-DQ2-DQ8) and/or serology and/or symptoms of the coeliac disease spectrum. When enteropathy was found, causes, including gluten sensitivity, were investigated and categorized according to a sequentially applied treatment. Results were analysed with Chi-square or Fisher exact tests.

RESULTS

The prevalence of coeliac disease with atrophy was 0.55% (1 of 183 patients). Thirty-eight of the 109 patients (34.8%) who underwent duodenal biopsy had lymphocytic enteropathy (8 infectious, 5 due to gluten sensitive enteropathy, 5 HLA-DQ2/DQ8 who did not accept gluten-free diet and 20 of unknown aetiology). Lymphocytic enteropathy was unrelated to disease activity or immunosuppressants. HLA-DQ2 was more frequent in connective tissue disease (41.5%) compared with systemic vasculitis and autoinflammatory diseases (17.9%) (p=0.02), whereas a lower percentage of lymphocytic enteropathy was observed in the former (20.2% vs. 41.6%). Lymphocytic enteropathy was clinically irrelevant in cases with no definite aetiology.

DISCUSSION

One third of systemic autoimmune diseases patients had enteropathy of uncertain clinical meaning in the majority of cases, which was rarely due to gluten sensitive enteropathy.

Authors+Show Affiliations

Department of Internal Medicine, Hospital Universitari MútuaTerrassa, Fundació per la Recerca MútuaTerrassa, Universitat de Barcelona, Plaza Dr. Robert 5, Terrassa, Catalonia, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22465228

Citation

Vives, Maria-José, et al. "Prevalence and Clinical Relevance of Enteropathy Associated With Systemic Autoimmune Diseases." Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, vol. 44, no. 8, 2012, pp. 636-42.
Vives MJ, Esteve M, Mariné M, et al. Prevalence and clinical relevance of enteropathy associated with systemic autoimmune diseases. Dig Liver Dis. 2012;44(8):636-42.
Vives, M. J., Esteve, M., Mariné, M., Fernández-Bañares, F., Alsina, M., Salas, A., Loras, C., Carrasco, A., Almagro, P., Viver, J. M., & Rodriguez-Carballeira, M. (2012). Prevalence and clinical relevance of enteropathy associated with systemic autoimmune diseases. Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 44(8), 636-42. https://doi.org/10.1016/j.dld.2012.02.013
Vives MJ, et al. Prevalence and Clinical Relevance of Enteropathy Associated With Systemic Autoimmune Diseases. Dig Liver Dis. 2012;44(8):636-42. PubMed PMID: 22465228.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and clinical relevance of enteropathy associated with systemic autoimmune diseases. AU - Vives,Maria-José, AU - Esteve,Maria, AU - Mariné,Meritxell, AU - Fernández-Bañares,Fernando, AU - Alsina,Montserrat, AU - Salas,Antonio, AU - Loras,Carme, AU - Carrasco,Anna, AU - Almagro,Pere, AU - Viver,Josep M, AU - Rodriguez-Carballeira,Mónica, Y1 - 2012/04/01/ PY - 2011/06/29/received PY - 2012/01/24/revised PY - 2012/02/19/accepted PY - 2012/4/3/entrez PY - 2012/4/3/pubmed PY - 2013/1/15/medline SP - 636 EP - 42 JF - Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver JO - Dig Liver Dis VL - 44 IS - 8 N2 - OBJECTIVE: To assess whether systemic autoimmune diseases are a risk group for coeliac disease and if there is a systemic autoimmune diseases-associated enteropathy. METHODS: 183 patients with systemic autoimmune diseases were included. Duodenal biopsy was carried out on patients with positive coeliac genetics (HLA-DQ2-DQ8) and/or serology and/or symptoms of the coeliac disease spectrum. When enteropathy was found, causes, including gluten sensitivity, were investigated and categorized according to a sequentially applied treatment. Results were analysed with Chi-square or Fisher exact tests. RESULTS: The prevalence of coeliac disease with atrophy was 0.55% (1 of 183 patients). Thirty-eight of the 109 patients (34.8%) who underwent duodenal biopsy had lymphocytic enteropathy (8 infectious, 5 due to gluten sensitive enteropathy, 5 HLA-DQ2/DQ8 who did not accept gluten-free diet and 20 of unknown aetiology). Lymphocytic enteropathy was unrelated to disease activity or immunosuppressants. HLA-DQ2 was more frequent in connective tissue disease (41.5%) compared with systemic vasculitis and autoinflammatory diseases (17.9%) (p=0.02), whereas a lower percentage of lymphocytic enteropathy was observed in the former (20.2% vs. 41.6%). Lymphocytic enteropathy was clinically irrelevant in cases with no definite aetiology. DISCUSSION: One third of systemic autoimmune diseases patients had enteropathy of uncertain clinical meaning in the majority of cases, which was rarely due to gluten sensitive enteropathy. SN - 1878-3562 UR - https://www.unboundmedicine.com/medline/citation/22465228/Prevalence_and_clinical_relevance_of_enteropathy_associated_with_systemic_autoimmune_diseases_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1590-8658(12)00068-0 DB - PRIME DP - Unbound Medicine ER -