Abstract
Objectives Autoimmune diseases (AD) may be associated with coeliac disease (CD), but specific risk factors have been poorly investigated. The aim of this study was to assess the spectrum of AD and its specific risk factors associated in a series of adult coeliac patients. Materials and Methods We performed a single-center case-control study including adult newly diagnosed CD patients. To evaluate the risk factors of the association between AD and CD, 341 coeliac patients included were categorized on the basis of AD presence: 91 cases with at least one AD and 250 controls without AD were compared for clinical, serological, and histological features. Eighty-seven cases were age-gender-matched with 87 controls. Results Among 341 CD patients, 26.6% of CD patients had at least one AD. Endocrine and dermatological diseases were the most prevalent AD encountered: autoimmune thyroiditis was present in 48.4% of cases, psoriasis in 17.6%, and type I diabetes and dermatitis herpetiformis in 11%, respectively. At logistic regression, factors associated with AD were a positive 1st-degree family history of AD (OR 3.7, 95% CI 1.93–7), a body mass index ≥ 25 kg/m2 at CD diagnosis (OR 2.95%, CI 1.1–3.8), and long standing presentation signs/symptoms before CD diagnosis (>10 years) (OR 2.1, 95% CI 1.1–3.7). Analysis on age-gender-matched patients confirmed these results. Conclusions CD patients with family history of AD, overweight at CD diagnosis, and a delay of CD diagnosis had an increased risk of having another AD. The benefit of CD screening in these specific subsets of patients with AD awaits further investigation.
Highlights
Coeliac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of gluten-containing grains in genetically susceptible persons
The aim of the present study was to assess the spectrum of autoimmune disorders (AD) and its specific risk factors associated in a series of adult CD patients
One AD was present in 81.3% (n = 74), and more than one AD in 18.7% (n = 17) of cases; when more than one AD was associated, autoimmune thyroiditis was the most frequent (64.7%)
Summary
Coeliac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of gluten-containing grains in genetically susceptible persons. In CD patients, a significantly increased prevalence of autoimmune disorders (AD), including systemic diseases and organspecific diseases, has been reported compared to healthy controls, with an estimated prevalence ranging from 15 to 30% [3, 4]. Screening for CD is recommended in patients affected by type I diabetes mellitus and autoimmune thyroid disease [5]. The association among CD and AD has been suggested to be due to shared genetic features between CD and other immune-mediated conditions, similar environmental triggers, and the loss of intestinal barrier [6, 7]. The aim of the present study was to assess the spectrum of AD and its specific risk factors associated in a series of adult CD patients
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