Celiac Disease and Autoimmune-Associated Conditions

Abstract

Celiac disease (CD) is frequently accompanied by a variety of extradigestive manifestations, thus making it a systemic disease rather than a disease limited to the gastrointestinal tract. This is primarily explained by the fact that CD belongs to the group of autoimmune diseases. The only one with a known etiology is related to a permanent intolerance to gluten. Remarkable breakthroughs have been achieved in the last decades, due to a greater interest in the diagnosis of atypical and asymptomatic patients, which are more frequent in adults. The known presence of several associated diseases provides guidance in the search of oligosymptomatic cases as well as studies performed in relatives of patients with CD. The causes for the onset and manifestation of associated diseases are diverse; some share a similar genetic base, like type 1 diabetes mellitus (T1D); others share pathogenic mechanisms, and yet, others are of unknown nature. General practitioners and other specialists must remember that CD may debut with extraintestinal manifestations, and associated illnesses may appear both at the time of diagnosis and throughout the evolution of the disease. The implementation of a gluten-free diet (GFD) improves the overall clinical course and influences the evolution of the associated diseases. In some cases, such as iron deficiency anemia, the GFD contributes to its disappearance. In other disorders, like T1D, this allows a better control of the disease. In several other complications and/or associated diseases, an adequate adherence to a GFD may slow down their evolution, especially if implemented during an early stage.

Age-related differences in celiac disease: Specific characteristics of adult presentation

“…However, the presence of associated pathologies in adults seems to be more frequent and may have an autoimmune origin like CD. Autoimmune disorders such as autoimmune thyroiditis, type Ⅰ diabetes, Sjögren's syndrome or dermatitis herpetiformis have been linked to CD [14,15] . Even though malnutrition is a frequent manifestation in CD, mainly in adults, excessive weight or obesity may also be present at diagnosis.…”

Gluten-free Diet - Tough Alley in Torrid Time

“…Interestingly, the CD trend parallels the surge in many other autoimmune diseases, not only in the gastrointestinal domain [36]. A well-known observation is the age-dependent increase of autoimmune disease in the CD patients and even in their close relatives [51,52,53]. …”

Correlation of Tissue Antibodies and Food Immune Reactivity in Randomly Selected Patient Specimens

“…Our IgG positive group excluded IgA positive specimens so as to prevent using possible celiac patients in the group. The link between Celiac disease and additional extraintestinal disorders has been well-established [25][26][27]. What hasn't been fully discussed is the link between non-celiac gluten sensitivity (NCGS) and autoimmunity.…”