Primary Sjögren's syndrome in patients with celiac disease

Primary Sjögren's syndrome in patients with celiac disease

Background/aim: Many autoimmune diseases occur concomitantly with celiac disease (CD). We aimed to determine the frequency of Sjögren s syndrome (SS) in CD patients based on SS-specific serology verified by minor labial salivary biopsy. Materials and methods: Eight-two patients with CD were included in the study. After examination for objective evidence of sicca complex, all patients were tested for serological presence of rheumatoid factor (RF) and antinuclear antibodies (ANAs) and for ANA profile. Minor labial salivary biopsy was performed for patients with positive serology and/or clinical signs of SS. Results: Of the patients included, 24 (29.3%) had dry eye symptoms while 20 (24.4%) had dry mouth symptoms. Dry eye was detected by Schirmer test in 10 patients (12.2%) and by ocular staining score in only 2 patients (2.4%). All samples were negative for RF while 12 (14.6%) samples were positive for ANAs. Of 82 patients with CD, the diagnosis of SS was established in only one patient (1.2%), while one patient (1.2%) was diagnosed with morphea and 4 patients (4.9%) were classified as having undifferentiated connective tissue disease. Conclusion: The prevalence of SS in CD is low, so there is no need for serologic screening of all patients with CD for SS.

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  • 1. Moutsopoulos HM, Bombardieri S. Sjogren’s syndrome. Rheumatology in Europe 1995; 24: 44-45.
  • 2. Fox RI, Chan EK, Kang HI. Laboratory evaluation of patients with Sjögren’s syndrome. Clin Biochem 1992; 25: 213-222.
  • 3. Sheikh SH, Shaw-Stiffel TA. The gastrointestinal manifestations of Sjögren’s syndrome. Am J Gastroenterol 1995; 90: 9-14.
  • 4. Green PH. The many faces of celiac disease: clinical presentation of celiac disease in the adult population. Gastroenterology 2005; 128 (Suppl. 1): S74-S78.
  • 5. Rashtak S, Marietta EV, Murray JA. Celiac sprue: a unique autoimmune disorder. Expert Rev Clin Immunol 2009; 5: 593- 604.
  • 6. Pittman FE, Holub DA. Sjögren’s syndrome and adult celiac disease. Gastroenterology 1965; 48: 869-876.
  • 7.  Iltanen S, Collin P, Korpela M, Holm K, Partanen J, Polvi A, Maki M. Celiac disease and markers of celiac disease latency in patients with primary Sjögren’s syndrome. Am J Gastroenterol 1999; 94: 1042-1046.
  • 8. Sollid LM, Thorsby E. HLA susceptibility genes in celiac disease: genetic mapping and role in pathogenesis. Gastroenterology 1993; 105: 910-922.
  • 9. Kang HI, Fei HM, Saito I, Sawada S, Chen SL, Yi D, Chan E, Peebles C, Bugawan TL, Erlich HA et al. Comparison of HLA class II genes in Caucasoid, Chinese and Japanese patients with primary Sjögren’s syndrome. J Immunol 1993; 150: 3615-3623.
  • 10. Shiboski SC, Shiboski CH, Criswell L, Baer A, Challacombe S, Lanfranchi H, Schiødt M, Umehara H, Vivino F, Zhao Y et al. American College of Rheumatology classification criteria for Sjögren’s syndrome: a data-driven, expert consensus approach in the Sjögren’s International Collaborative Clinical Alliance cohort. Arthritis Care Res (Hoboken) 2012; 64: 475-487.
  • 11. Chisholm DM, Mason DK. Labial salivary gland biopsy in Sjogren’s disease. J Clin Path 1968; 21: 656-660.
  • 12. Szodoray P, Barta Z, Lakos G, Szakáll S, Zeher M. Coeliac disease in Sjögren’s syndrome--a study of 111 Hungarian patients. Rheumatol Int 2004; 24: 278-282.
  • 13. Collin P, Reunala T, Pukkala E, Laippala P, Keyrilainen O, Pasternack A. Coeliac disease--associated disorders and survival. Gut 1994; 35: 1215-1218.
  • 14. Iqbal T, Zaidi MA, Wells GA, Karsh J. Celiac disease arthropathy and autoimmunity study. J Gastroenterol Hepatol 2013; 28: 99- 105.
  • 15. Lubrano E, Ciacci C, Ames PR, Mazzacca G, Oriente P, Scarpa R. The arthritis of coeliac disease: prevalence and pattern in 200 adult patients. Br J Rheumatol 1996; 35: 1314-1318.
  • 16. Fasano A, Berti I, Gerarduzzi T, Not T, Colletti RB, Drago S, Elitsur Y, Green PH, Guandalini S, Hill ID et al. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Arch Intern Med 2003; 163: 286-292.
  • 17. Aine L, Maki M, Collin P, Kaeyrilainen O. Dental enamel defects in coeliac disease. J Oral Pathol Med 1990; 19: 241-245.
  • 18. Aguirre JM, Rodríguez R, Oribe D, Vitoria JC. Dental enamel defects in coeliac patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997; 84: 646-650.
  • 19. Lähteenoja H, Toivanen A, Viander M, Mäki M, Irjala K, Rähiä I, Syrjänen S. Oral mucosa changes in coeliac patients on a gluten-free diet. Eur J Oral Sci 1998; 106: 899-906.
  • 20. Patinen P,  Aine L,  Collin P, Hietanen J, Korpela M, Enckell G, Kautiainen H, Konttinen YT, Reunala T. Oral findings in coeliac disease and Sjögren’s syndrome. Oral Dis 2004; 10: 330- 334.
  • 21. Mollazadegan K, Kugelberg M, Tallstedt L, Ludvigsson JF. Increased risk of uveitis in coeliac disease: a nationwide cohort study. Br J Ophthalmol 2012; 96: 857-861.
  • 22. Mollazadegan K, Kugelberg M, Lindblad BE, Ludvigsson JF. Increased risk of cataract among 28,000 patients with celiac disease. Am J Epidemiol 2011; 174: 195-202.
  • 23. da Rosa Utiyama SR, da Silva Kotze LM, Nisihara RM, Carvalho RF, de Carvalho EG, de Sena MG, de Messias Reason IJ. Spectrum of autoantibodies in celiac patients and relatives. Dig Dis Sci 2001; 46: 2624-30.
  • 24. Caglar E, Ugurlu S, Ozenoglu A, Can G, Kadioglu P, Dobrucali A. Autoantibody frequency in celiac disease. Clinics 2009; 64: 1195-1200.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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