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There Is No Association Between Coeliac Disease and Autoimmune Pancreatitis

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There Is No Association Between Coeliac Disease and Autoimmune Pancreatitis

Giulia De Marchi et al. Nutrients.

Abstract

Autoimmune pancreatitis (AIP) is a rare disorder whose association with coeliac disease (CD) has never been investigated, although CD patients display a high prevalence of both endocrine and exocrine pancreatic affections. Therefore, we sought to evaluate the frequency of CD in patients with AIP and in further medical pancreatic disorders. The screening for CD was carried out through the detection of tissue transglutaminase (tTG) autoantibodies in sera of patients retrospectively enrolled and divided in four groups: AIP, chronic pancreatitis, chronic asymptomatic pancreatic hyperenzymemia (CAPH), and control subjects with functional dyspepsia. The search for anti-endomysium autoantibodies was performed in those cases with borderline or positive anti-tTG values. Duodenal biopsy was offered to all cases showing positive results. One patient out of 72 (1.4%) with AIP had already been diagnosed with CD and was following a gluten-free diet, while one case out of 71 (1.4%) with chronic pancreatitis and one out of 92 (1.1%) control subjects were diagnosed with de novo CD. No cases of CD were detected in the CAPH group. By contrast, a high prevalence of cases with ulcerative colitis was found in the AIP group (13.8%). Despite a mutual association between CD and several autoimmune disorders, our data do not support the serologic screening for CD in AIP. Further studies will clarify the usefulness of CD serologic screening in other pancreatic disorders.

Keywords: autoimmune pancreatitis; coeliac disease; pancreatic disorders; screening.

Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Histological features of duodenal mucosa of active coeliac disease showing subtotal villous atrophy with crypt hyperplasia and heavy lymphocytic inflammatory infiltrate in both the epithelial (arrows) and lamina propria (head arrows) compartments (hematoxylin-eosin, original magnification × 100).
Figure 2
Figure 2
Histological features of autoimmune pancreatitis showing a dense periductal infiltration of plasma cells and lymphocytes leading to obliteration of the affected veins (arrows), and peculiar storiform fibrosis (head arrows) (hematoxylin-eosin, original magnification × 100).
Figure 3
Figure 3
Abdominal magnetic resonance scan showing a diffuse enlargement of the body of the pancreas, with a “sausage-like” aspect (A), and multiple long stenosis of the main pancreatic duct at the cholangiopancreatography sequences (B).

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