Coeliac disease and malignancies

Ferguson, Anne; Kingstone, Kathleen

doi:10.1111/j.1651-2227.1996.tb14259.x

Cited by 55 publications

(29 citation statements)

References 14 publications

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“…Elegant studies have been performed to assess a genetic involvement in the progression of Addison's disease. These studies looked at the association of Addison's disease, the presence of 21-hydroxylase autoantibodies, and DQ2 or DQ8 class II molecules (27). It was shown that DQ8 ϩ patients with 21-hydroxylase autoantibodies had clinical Addison's disease.…”

Section: Autoimmune Endocrine Disorders and CDmentioning

confidence: 99%

Celiac Disease-Associated Autoimmune Endocrinopathies

Kumar

Rajadhyaksha

Wortsman

2001

Clin Diagn Lab Immunol

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3Celiac disease (CD) is an autoimmune disorder induced by gluten intake in genetically susceptible individuals. It is characterized by the presence of serum antibodies to endomysium, reticulin, gliadin, and tissue transglutaminase. The incidence of CD in various autoimmune disorders is increased 10-to 30-fold in comparison to the general population, although in many cases CD is clinically asymptomatic or silent. The identification of such cases with CD is important since it may help in the control of type I diabetes or endocrine functions in general, as well as in the prevention of long-term complications of CD, such as lymphoma. It is believed that CD may predispose an individual to other autoimmune disorders such as type I diabetes, autoimmune thyroid, and other endocrine diseases and that gluten may be a possible trigger. The onset of type I diabetes at an early age in patients with CD, compared to non-CD, and the prevention or delay in onset of diabetes by gluten-free diet in genetically predisposed individuals substantiates this antigen trigger hypothesis. Early identification of CD patients in highly susceptible population may result in the treatment of subclinical CD and improved control of associated disorders.Autoimmunity as a concept evolved from the beginning of this century, when Ehrlich and Morgenroth (26) introduced the phenomenon of "horror autotoxicus," i.e., fear of selfpoisoning. Subsequently, many diseases were recognized with etiology arising from the abnormal reaction of the immune system to self antigens. These observations laid the foundation for establishing postulates that are characteristic of an autoimmune disease (4, 7). Since then, several hypotheses have been put forward regarding the mechanisms of autoimmunity (22,76,84,110,118).In general, autoimmune disorders can be classified as either organ specific or non-organ specific. In organ-specific autoimmune diseases, the autoantibodies are specifically directed against antigens localized in a particular organ and are often detected in circulation. Examples of organ-specific autoimmunity include Hashimoto's thyroiditis, type I diabetes, and myasthenia gravis.In contrast, the non-organ-specific autoimmune disorders are characterized by the presence of autoantibodies directed against ubiquitous antigens (not specific to a particular organ). This results in the involvement of several organs and is often characterized by the presence of specific circulating immune complexes. Non-organ-specific autoimmunity includes diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and scleroderma.Epidemiologic studies have shown that genetic factors are involved in host susceptibility to autoimmune disease. For example, the concordance rate of a particular autoimmune diseases is much higher in monozygotic twins in comparison to fraternal twins (17). Moreover, this incidence is much higher in organ-specific autoimmune disorders in comparison to nonorgan-specific disorders. Thus, in Grave's thyrotoxicosis, Hashimoto's disease, a...

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Section: Autoimmune Endocrine Disorders and CDmentioning

confidence: 99%

Celiac Disease-Associated Autoimmune Endocrinopathies

Kumar

Rajadhyaksha

Wortsman

2001

Clin Diagn Lab Immunol

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“…6 Several other chronic inflammatory or autoimmune diseases, such as inflammatory bowel disease, 7 rheumatoid arthritis, 8 systemic lupus erytematosus, 9 Sjögren's syndrome, 10 sarcoidosis 11 and coeliac disease, 12 are also associated with an increased occurrence of cancer. In particular, an excess risk of malignant lymphomas in rheumatoid arthritis, SLE, Sjögren's syndrome and coeliac disease has been reported, as have cancers of the afflicted tissues in inflammatory bowel disease (colorectal cancer), 7 coeliac disease (small intestine carcinomas) 13 and in primary sclerosing cholangitis (cholangiocarcinoma). 14 There have in fact been reports of a highly increased risk for cancer of the urinary bladder and for non-Hodgkin's lymphoma among Wegener's granulomatosis patients, but the patient series have been small and highly selected.…”

mentioning

confidence: 99%

Cancer incidence in a population‐based cohort of patients with Wegener's granulomatosis

Knight

Askling

Ekbom

2002

Intl Journal of Cancer

177

139

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Wegener's granulomatosis is necrotizing granulomatous vasculitis of unknown origin, which untreated has a high mortality within the first year of onset. The introduction of corticosteroids and cyclophosphamide in the treatment has considerably improved survival rates, but past studies have indicated an increased cancer risk, including an increased risk for urinary bladder cancer. No large assessment of the general cancer occurrence in Wegener's granulomatosis has been reported. The aim of our study was to assess the general incidence of cancer in patients with Wegener's granulomatosis and to put this in relation to the risk for bladder cancer. We identified a population-based cohort of 1,065 patients with Wegener's granulomatosis in the Swedish Inpatient Register. Through linkage with the Swedish Cancer Register, we followed the cohort for cancer occurrence for up to 26 years. Standardized incidence ratios (SIR) between observed and expected numbers of cancers were used as a measure of relative risk. There was a 2-fold overall increased risk for cancer in the cohort. The increase was most pronounced for bladder cancer (SIR ‫؍‬ 4.8; 95% CI 2.6 -8.1), squamous cell skin cancer (SIR ‫؍‬ 7.3; 95% CI 4.4 -12), leukemias (SIR ‫؍‬ 5.7; 95% CI 2.3-12) and for malignant lymphomas (SIR ‫؍‬ 4.2; 95% CI 4.2-8.3). The results confirm previous indications of an increased risk for cancer of the urinary bladder but also points to increased risks for cancer at other sites.

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“…O aconselhamento à obediência da dieta isenta de glúten para os pacientes com doença celíaca é importante na prevenção de complicações não-malignas (14) e especialmente aquelas com risco de malignidade (10,13,17) . A avaliação da obediência à dieta e do conhecimento da DC e de seu tratamento possibilitou confirmar a possível relação positiva entre ambas, isto é, quanto maior o conhecimento da DC e de seu tratamento, maior o grau de obediência à dieta isenta de glúten.…”

Section: Discussionunclassified

“…É de fundamental importância o cumprimento efetivo da dieta sem glúten a fim de assegurar desenvolvimento pôndero-estatural e puberal adequados (12) , densidade mineral óssea (6) , fertilidade (22) , redução de risco de deficiência de macro e micronutrientes (7) , assim como, diminuir o risco do surgimento de doenças malignas (10,13,17) , particularmente do sistema digestivo. A obediência à dieta totalmente isenta de trigo, centeio, cevada, malte e aveia não constitui prática de fácil exeqüibilidade (8) .…”

Section: Introductionunclassified