Increased prevalence of celiac disease in idiopathic inflammatory myopathies

Brain Behav. 2017 Sep 5;7(10):e00803. doi: 10.1002/brb3.803. eCollection 2017 Oct.

Abstract

Objectives: Idiopathic inflammatory myopathies (IIM) are often associated with other immune-mediated diseases or malignancy. Some studies have reported a high frequency of celiac disease in IIM. The aim of this study was to investigate the prevalence of celiac disease, systemic inflammatory diseases, and malignancy in a cohort of IIM patients, and estimate the incidence of IIM in the county of Östergötland, Sweden.

Material and methods: We reviewed medical records and analyzed sera from 106 patients, fulfilling pathological criteria of inflammatory myopathy, for the presence of IgA antibodies against endomysium and gliadin. Antibody-positive patients were offered further investigation with small bowel biopsy or investigation for the presence of antibodies against antitissue transglutaminase (t-TG). The patients were classified according to Bohan and Peter or Griggs criteria. The presence of celiac disease, systemic inflammatory, and malignant diseases was documented.

Results: Four of 88 patients classified as IIM (4.5%) had biopsy-confirmed celiac disease, which is higher than the prevalence in the general population, detected with a similar screening procedure (0.53%). Thirty-three patients (38%) had a systemic inflammatory disease and five (5.7%) a malignancy. The incidence of confirmed IIM in the county of Östergötland was 7.3 per million/year.

Conclusions: The results highlight the high frequency of associated inflammatory and malignant diseases and confirm an increased prevalence of celiac disease in IIM.

Keywords: celiac disease; idiopathic inflammatory myopathies; incidence; myositis; prevalence.

MeSH terms

  • Adult
  • Aged
  • Antibodies / analysis
  • Biopsy / methods
  • Celiac Disease* / epidemiology
  • Celiac Disease* / immunology
  • Celiac Disease* / pathology
  • Cohort Studies
  • Female
  • Gliadin / immunology
  • Humans
  • Incidence
  • Intestine, Small / pathology*
  • Male
  • Middle Aged
  • Muscle, Smooth / immunology
  • Muscle, Smooth / pathology
  • Myositis* / epidemiology
  • Myositis* / immunology
  • Myositis* / pathology
  • Neoplasms / epidemiology
  • Prevalence
  • Sweden / epidemiology

Substances

  • Antibodies
  • Gliadin