Is there a relationship between gluten sensitivity and postural tachycardia syndrome?

Eur J Gastroenterol Hepatol. 2016 Dec;28(12):1383-1387. doi: 10.1097/MEG.0000000000000740.

Abstract

Background: We have noticed that patients with postural tachycardia syndrome (PoTS) were placing themselves on a gluten-free diet without medical consultation. Therefore, we aimed to evaluate the prevalence of coeliac disease and self-reported gluten sensitivity in a cohort of patients with PoTS and compare this with local population data.

Methods: A total of 100 patients with PoTS were recruited to complete a questionnaire that screened for gluten sensitivity, related symptoms and dietary habits. Patients were also assessed for coeliac disease. For comparison, the local coeliac prevalence was determined from a total of 1200 controls (group 1) and a further 400 controls (group 2), frequency matched for age and sex, who completed the same questionnaire.

Results: Overall, 4/100 (4%) patients with PoTS had serology and biopsy-proven coeliac disease. This was significantly higher than the local population prevalence of coeliac disease (12/1200, 1%; odds ratio: 4.1, 95% confidence interval: 1.3-13.0; P=0.03). PoTS patients also had a higher prevalence of self-reported gluten sensitivity (42 vs. 19%, respectively; odds ratio: 3.1, 95% confidence interval: 2.0-5.0; P<0.0001) compared with age-matched and sex-matched controls.

Conclusion: This is the first study to suggest a potential association between gluten-related disorders and PoTS. A prospective study evaluating this relationship further may enable a better understanding and management of these conditions.

MeSH terms

  • Adult
  • Autoantibodies / immunology
  • Biopsy
  • Celiac Disease / diagnosis
  • Celiac Disease / epidemiology*
  • Celiac Disease / immunology
  • Celiac Disease / pathology
  • Duodenum / pathology
  • Endoscopy, Digestive System
  • Female
  • Fibromyalgia / epidemiology
  • GTP-Binding Proteins / immunology
  • Humans
  • Joint Instability / epidemiology
  • Male
  • Odds Ratio
  • Postural Orthostatic Tachycardia Syndrome / epidemiology*
  • Prevalence
  • Protein Glutamine gamma Glutamyltransferase 2
  • Risk Factors
  • Self Report
  • Surveys and Questionnaires
  • Transglutaminases / immunology
  • Young Adult

Substances

  • Autoantibodies
  • Protein Glutamine gamma Glutamyltransferase 2
  • Transglutaminases
  • GTP-Binding Proteins