High prevalence of celiac disease in psoriasis

Ojetti, Veronica; Sanchez, Jose A.; Guerriero, Cristina; Fossati, Barbara; Capizzi, Rodolfo; Simone, Clara De; Migneco, Alessio; Amerio, Pierluigi; Gasbarrini, Giovanni; Gasbarrini, Antonio

doi:10.1111/j.1572-0241.2003.08684.x

Cited by 26 publications

(6 citation statements)

References 5 publications

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“…A link between psoriasis and CD was proposed by early studies [27,28,29,30] and controverted by others [31]. The prevalence of CD increases 2-4-fold in the population with psoriasis.…”

Section: Mucocutaneous Manifestations Of CDmentioning

confidence: 99%

Extraintestinal Manifestations of Celiac Disease

Pinto-Sanchez¹,

Berčík²,

Verdú³

et al. 2015

Dig Dis

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Case finding for celiac disease (CD) is becoming increasingly common practice and is conducted in a wide range of clinical situations ranging from the presence of gastrointestinal symptoms to failure to thrive in children, prolonged fatigue, unexpected weight loss and anemia. Case finding is also performed in associated conditions, such as autoimmune thyroid disease, dermatitis herpetiformis and type 1 diabetes, as well as in patients with irritable bowel syndrome, unexplained neuropsychiatric disorders and first-degree relatives of patients with diagnosed CD. This aggressive active case finding has dramatically changed the clinical characteristics of newly diagnosed patients. For instance, higher numbers of patients who present with extraintestinal symptoms are now being diagnosed with CD. Current recommendations state that due to a high risk for complications if the disease remains undiagnosed, patients with extraintestinal symptoms due to CD require appropriate diagnosis and treatment. Despite criticism regarding the cost-effectiveness of case finding in CD, such an aggressive approach has been considered cost-effective for high-risk patients. The diagnosis of CD among patients with extraintestinal symptoms requires a high degree of awareness of the clinical conditions that carry a high risk for underlying CD. Also, understanding the correct use of specific serology and duodenal histology is key for an appropriate diagnostic approach. Both procedures combined are able to confirm diagnosis in the vast majority of cases. However, in certain circumstances, serology and even duodenal histology cannot confirm or rule out CD. A common cause of negative IgA serology is IgA deficiency. For such eventuality, IgG-based serological tests can help confirm the diagnosis. Importantly, some histologically diagnosed cases still remain seronegative despite exclusion of IgA deficiency. On the other hand, duodenal histology may be normal despite the presence of CD-specific antibodies and active CD. This has been clearly demonstrated in some cases of untreated dermatitis herpetiformis, but may also be due to the patchy condition of CD or lesions that are not adequately recognized by nonexpert endoscopists and/or pathologists. The effectiveness of agluten-free diet depends on the clinical end point addressed. A good example is the outcome of bone loss. While risk for fracture normalizes after the first year of dietary treatment, bone parameters measured by densitometry may not be normalized in the long-term follow-up. Moreover, it is still unclear how far an early gluten-free diet will positively affect associated autoimmune diseases like type 1 diabetes and autoimmune thyroiditis.

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“…A link between psoriasis and CD was proposed by early studies [27,28,29,30] and controverted by others [31]. The prevalence of CD increases 2-4-fold in the population with psoriasis.…”

Section: Mucocutaneous Manifestations Of CDmentioning

confidence: 99%

Extraintestinal Manifestations of Celiac Disease

Pinto-Sanchez¹,

Berčík²,

Verdú³

et al. 2015

Dig Dis

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Section: Discussionmentioning

confidence: 99%

“…Several controlled studies have supported the association between celiac biomarkers and psoriasis [ 8 – 10 , 18 – 21 ]. However, these studies did not examine the potential effects of comorbidities, involvement patterns, or immunosuppressive treatments on celiac antibodies [ 8 – 10 , 18 – 21 ]. Unlike our study, the fact that psoriasis patients with symptoms suggestive of CD were also included in these studies may have affected the results.…”

Section: Discussionmentioning

confidence: 99%

Screening of antigliadin and antitissue transglutaminase antibodies in patients with chronic plaque psoriasis: a case-control study

ENGİN¹,

HUSEYNOVA²,

AK³

et al. 2023

Turkish Journal of Medical Sciences

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Background/aim In this study, we aimed to investigate different types of celiac antibodies in psoriasis patients and to see if the presence of the antibodies was associated with other variables. Materials and methods We included patients with plaque psoriasis who were followed up in our dermatology clinic between February 2019 and February 2021 and added a healthy control group for comparison. The antibodies studied were serum antitissue transglutaminase (tTG)-IgA, tTG-IgG, antigliadin antibody (AGA)-IgA, and AGA-IgG. The patients’ records were used to note age, sex, the pattern of psoriasis involvement, psoriasis area and severity index (PASI), presence of hypertension, presence of type 2 diabetes mellitus, use of methotrexate, and use of biologic agents. Results Sixty-five psoriasis patients (31 F, 34 M, mean age: 38.9 ± 15.2) and 65 controls (42 F, 23 M, mean age: 40.7 ± 13.2) were included in the study. There was no significant difference in antibody levels between the groups: tTG-IgA (2.4 U/mL vs 3.2 U/mL, p = 0.11), tTG-IgG (2.2 U/mL vs 3.2 U/mL, p = 0.74), AGA-IgA (2.4 U/mL vs 3.5 U/mL, p = 0.068), and AGA-IgG (3.2 U/mL vs 4.2 U/mL, p = 0.15). One patient from the psoriasis group only had borderline positive antibody levels whereas the rest of the psoriasis and control group had negative levels. Hypertensive psoriasis patients had significantly higher AGA-IgA titers compared to normotensive psoriasis patients (4.2 U/mL vs 2.3 U/mL, p = 0.005). Conclusion There was no increase in the AGA-IgA/IgG and tTG-IgA/IgG levels in psoriasis patients compared to the healthy population. However, hypertensive psoriasis patients had higher AGA-IgA levels compared to normotensive ones.

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“…[20][21][22] It has long been accepted that psoriasis is not confined to the skin, also affecting nails and joints, but recent studies have proposed psoriasis as a systemic illness, with multiple organ system involvement. 23 Epidemiological studies have shown an increase in the prevalence of celiac disease in patients with psoriasis, 19,20,[24][25][26] including a case-control study of 12,502 patients with psoriasis, which demonstrated an association (odds ration [OR] = 2.70) in all age groups, although the association strength decreased as age increased. 27 Similarly, a case-control study of 11,793 children diagnosed with celiac disease <20 years of age, between 1969 and 2008, demonstrated a significant risk of developing psoriasis later in life (hazard ration [HR] = 2.05), and 51.3% of psoriasis could be attributed to the underlying celiac disease 20 (Table 1).…”

Section: Psoriasismentioning

confidence: 99%

Could it be gluten? Additional skin conditions associated with celiac disease

2021

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Celiac disease is a multifactorial, inflammatory disorder initiated and sustained by the ingestion of gluten. Occurring across a broad population, the intestinal and extraintestinal manifestations of celiac disease are variable in severity and may be nonspecific in presentation. Given that environmental, genetic, and immune factors involved in the pathogenesis of celiac disease that the digestive tract and skin share many characteristics, and with a prevalence of 0.5-1% in most populations, it is reasonable to consider varying presentations of skin conditions that are linked with celiac disease. The association between celiac disease and skin conditions has been discussed earlier, but new studies have emerged suggesting cutaneous involvement in addition to dermatitis herpetiformis.We review the current literature identifying the relationship and potential mechanisms between celiac disease and various skin conditions.

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High prevalence of celiac disease in psoriasis

Cited by 26 publications

References 5 publications

Extraintestinal Manifestations of Celiac Disease

Extraintestinal Manifestations of Celiac Disease

Screening of antigliadin and antitissue transglutaminase antibodies in patients with chronic plaque psoriasis: a case-control study

Could it be gluten? Additional skin conditions associated with celiac disease

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