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Fibromyalgia and non-celiac gluten sensitivity: a description with remission of fibromyalgia.

Abstract

Fibromyalgia (FM) syndrome is a disabling clinical condition of unknown cause, and only symptomatic treatment with limited benefit is available. Gluten sensitivity that does not fulfill the diagnostic criteria for celiac disease (CD) is increasingly recognized as a frequent and treatable condition with a wide spectrum of manifestations that overlap with the manifestations of FM, including chronic musculoskeletal pain, asthenia, and irritable bowel syndrome. The aim of this report was to describe 20 selected patients with FM without CD who improved when placed on a gluten-free diet. An anti-transglutaminase assay, duodenal biopsy, and HLA typing were performed in all cases. CD was ruled out by negative anti-transglutaminase assay results and absence of villous atrophy in the duodenal biopsy. All patients had intraepithelial lymphocytosis without villous atrophy. Clinical response was defined as achieving at least one of the following scenarios: remission of FM pain criteria, return to work, return to normal life, or the discontinuation of opioids. The mean follow-up period was 16 months (range 5-31). This observation supports the hypothesis that non-celiac gluten sensitivity may be an underlying cause of FM syndrome.

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    ,

    Department of Rheumatology, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain, carlos.isasi@gmail.com.

    , , , , , ,

    Source

    Rheumatology international 34:11 2014 Nov pg 1607-12

    MeSH

    Adult
    Aged
    Biopsy
    Diet, Gluten-Free
    Duodenum
    Female
    Fibromyalgia
    Food Hypersensitivity
    Glutens
    Humans
    Lymphocytosis
    Middle Aged
    Predictive Value of Tests
    Remission Induction
    Retrospective Studies
    Risk Factors
    Spain
    Time Factors
    Treatment Outcome

    Pub Type(s)

    Journal Article
    Multicenter Study

    Language

    eng

    PubMed ID

    24728027

    Citation

    Isasi, Carlos, et al. "Fibromyalgia and Non-celiac Gluten Sensitivity: a Description With Remission of Fibromyalgia." Rheumatology International, vol. 34, no. 11, 2014, pp. 1607-12.
    Isasi C, Colmenero I, Casco F, et al. Fibromyalgia and non-celiac gluten sensitivity: a description with remission of fibromyalgia. Rheumatol Int. 2014;34(11):1607-12.
    Isasi, C., Colmenero, I., Casco, F., Tejerina, E., Fernandez, N., Serrano-Vela, J. I., ... Villa, L. F. (2014). Fibromyalgia and non-celiac gluten sensitivity: a description with remission of fibromyalgia. Rheumatology International, 34(11), pp. 1607-12. doi:10.1007/s00296-014-2990-6.
    Isasi C, et al. Fibromyalgia and Non-celiac Gluten Sensitivity: a Description With Remission of Fibromyalgia. Rheumatol Int. 2014;34(11):1607-12. PubMed PMID: 24728027.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Fibromyalgia and non-celiac gluten sensitivity: a description with remission of fibromyalgia. AU - Isasi,Carlos, AU - Colmenero,Isabel, AU - Casco,Fernando, AU - Tejerina,Eva, AU - Fernandez,Natalia, AU - Serrano-Vela,José I, AU - Castro,Maria J, AU - Villa,Luis F, Y1 - 2014/04/12/ PY - 2013/11/10/received PY - 2014/03/10/accepted PY - 2014/4/15/entrez PY - 2014/4/15/pubmed PY - 2015/7/7/medline SP - 1607 EP - 12 JF - Rheumatology international JO - Rheumatol. Int. VL - 34 IS - 11 N2 - Fibromyalgia (FM) syndrome is a disabling clinical condition of unknown cause, and only symptomatic treatment with limited benefit is available. Gluten sensitivity that does not fulfill the diagnostic criteria for celiac disease (CD) is increasingly recognized as a frequent and treatable condition with a wide spectrum of manifestations that overlap with the manifestations of FM, including chronic musculoskeletal pain, asthenia, and irritable bowel syndrome. The aim of this report was to describe 20 selected patients with FM without CD who improved when placed on a gluten-free diet. An anti-transglutaminase assay, duodenal biopsy, and HLA typing were performed in all cases. CD was ruled out by negative anti-transglutaminase assay results and absence of villous atrophy in the duodenal biopsy. All patients had intraepithelial lymphocytosis without villous atrophy. Clinical response was defined as achieving at least one of the following scenarios: remission of FM pain criteria, return to work, return to normal life, or the discontinuation of opioids. The mean follow-up period was 16 months (range 5-31). This observation supports the hypothesis that non-celiac gluten sensitivity may be an underlying cause of FM syndrome. SN - 1437-160X UR - https://www.unboundmedicine.com/medline/citation/24728027/full_citation L2 - https://dx.doi.org/10.1007/s00296-014-2990-6 DB - PRIME DP - Unbound Medicine ER -