Primary Sjögren’s syndrome in patients with celiac disease

Erbasan, Funda; Çoban, Deniz; Karasu, Uğur; Çekın, Yeşim; Yeşil, Bayram; Çekın, Ayhan Hilmi; Süren, Di̇nç; Terzioğlu, Mustafa

doi:10.3906/sag-1601-149

Cited by 11 publications

(8 citation statements)

References 25 publications

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“…Some studies have shown a relationship between CD and ocular surface diseases, like dry eye. Dendritic cells and natural killer B and T cells are responsible for ocular surface inflammation [7, 8]. Besides the autoimmune response, deficiencies of vitamins due to malabsorption might contribute to dry eye in CD patients.…”

Section: Introductionmentioning

confidence: 99%

Pachychoroid Pigment Epitheliopathy and Choroidal Thickness Changes in Coeliac Disease

Bölükbaşı

Erden

Çakir

et al. 2019

Journal of Ophthalmology

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Purpose. To evaluate choroidal thickness in patients with coeliac disease (CD) using spectral domain optical coherence tomography (SD-OCT) and to compare the results to normal eyes. Methods. Seventy patients with CD and 70 healthy controls were included in this prospective, comparative study. All participants underwent a complete ophthalmologic evaluation and SD-OCT. Subfoveal, nasal (nasal distance to fovea 500 μm, 1000 μm, and 1500 μm), and temporal (temporal distance to fovea 500 μm, 1000 μm, and 1500 μm) choroidal thickness measurements were performed using SD-OCT. Results. There were no significant differences in sex, ages, and axial lengths between the groups (p=1.0, p=0.601, p=0.314, respectively). The mean choroidal thickness measurements at all predefined measurement point areas were higher in the coeliac group than in the healthy controls (p<0.001). Of all patients with coeliac disease (70 eyes of 70 patients), 64 eyes (84.2%) had uncomplicated pachychoroid (UCP), one eye had pachychoroid pigment epitheliopathy (PPE), and five eyes in the UCP group had PPE in fellow eyes. Conclusion. It is probable that systemic inflammation in coeliac patients causes the enlargement of choroidal vessels and increasing choroidal thickness. PPE, which is believed to be the precursor of central serous chorioretinopathy, can be observed in coeliac patients.

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Section: Introductionmentioning

confidence: 99%

Pachychoroid Pigment Epitheliopathy and Choroidal Thickness Changes in Coeliac Disease

Bölükbaşı

Erden

Çakir

et al. 2019

Journal of Ophthalmology

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“…Ayar et al[ 29 ] found a high frequency of dry eye/mouth in CD patients, with approximately one in four being symptomatic, but only few had a biopsy-based diagnosis of SS; the frequency of SS classified according to the 2012 ACR or to American-European Consensus Group criteria was 4.9%[ 29 ]. Similarly, in a small cohort of 82 CD patients, Erbasan et al[ 25 ] reported a high prevalence of dry eye (29.3%) and dry mouth (24.4%) symptoms; in this group, the diagnosis of SS was proven by biopsy in 1.2% of CD patients[ 25 ]. Moreover, four patients (4.9%) were diagnosed with undifferentiated connective tissue disease, two of them being positive for anti-SS-A/La antibodies, but having though negative biopsies.…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, other authors have also looked at the SS occurrence in CD patients, results of which are summarized in Table 2 [ 25 - 29 ]. Using the California criteria for SS, Collin et al[ 28 ] reported a prevalence of 3.3% for SS in patients with CD, a significant association in contrast with other connective tissue disease[ 28 ], while Caglar et al[ 27 ] reported a prevalence of 6.5% (SS-A/SS-B antibody)[ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…The antibody spectrum in CD and SS has been looked at in a few studies. On one hand, there is data supporting a high prevalence of antinuclear antibodies in patients with CD, ranging from 8.9% (da Rosa Utiyama et al[ 30 ]) to 14.6% (Erbasan et al[ 25 ]). Additionally, the anti-SS-A/Ro and anti-SS-B/La antibodies were reported to have a prevalence of 6.5% in 31 patients with CD[ 27 ].…”

Section: Discussionmentioning

confidence: 99%

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Celiac disease and Sjögren’s syndrome: A case report and review of literature

Balaban¹,

Mihai²,

Dima³

et al. 2020

WJCC

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BACKGROUND Celiac disease (CD) is a systemic, chronic immune-mediated disease triggered by gluten ingestion in genetically-susceptible individuals, with a prevalence of 1% worldwide. Sjogren's syndrome (SS) is also a systemic autoimmune disease, mainly characterized by ocular and oral sicca symptoms and signs. Sharing a common genetic background, CD and SS are known associated autoimmune diseases, but currently available guidelines are not reporting it. CASE SUMMARY We report the case of a 39-year-old woman, who was in the care of her rheumatologist for 2 years with SS. On routine follow-up she was found to have iron deficiency, without anemia. She had no gastrointestinal complaints and denied any obvious source of blood loss. IgA tissue transglutaminase antibodies were positive and endoscopy with duodenal biopsies revealed crypt hyperplasia and villous atrophy. A diagnosis of CD was set and gluten-free diet was recommended. CONCLUSION We present a review of existing data in the literature regarding the association of the two diseases, summarizing prevalence studies of CD in SS patients and the other way around. Screening recommendations and future research perspectives are also discussed, highlighting clinically relevant unanswered questions with respect to the association of CD with SS.

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“…Uzel et al 19 demonstrated that tear film break-up time and Schirmer test results were significantly lower and Goblet cell count remarkably diminished in CD. We did not test the tear film break-up time and Schirmer in our study but measured the corneal thickness by OCT. Primary Sjögren's syndrome is extremely rare in disease 20 . There are very few reports of posterior segment thickness measurements in CD-related literature.…”

Section: Discussionmentioning

confidence: 99%

Ocular Parameters Quantified by the Swept-Source Optical Coherence Tomography in Celiac Disease / Çölyak Hastalığında Swept-Source Optik Koherens Tomografi ile Ölçülen Oküler Parametreler

Yener¹,

Akpınar²,

Kahramanoğlu³

et al. 2020

Cumhuriyet Medical Journal

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To measure anterior and posterior segmental ocular parameters in patients with celiac disease using swept-source optical coherence tomography and compare with those of healthy subjects. Method: Fourteen patients with celiac disease referred from the gastroenterology clinic and 14 control subjects selected from the individuals with minor complaints who admitted the ophthalmology outpatient clinic were included in the study. Mean and segmental retinal nerve fiber layer thickness in four quadrant, average and sectoral ganglion cell inner plexiform layer thickness in six quadrant, foveal and parafoveal vessel density in four quadrant, optic nerve head parameters, including rim area, disc area, horizontal cup-to-disc ratio, vertical cup-to-disc ratio, cup volume, and additionally superficial/deep foveal avascular zone areas, choroidal thickness, and central corneal thickness of patients and controls were quantified using swept-source optical coherence tomography. Results: Among all the measurements, retinal nerve fiber layer in nasal quadrant and subfoveal choroid of patients were significantly thicker than those of controls. Nasal quadrant retinal nerve fiber layer thickness for patients and controls were 91.62±15.27 µm and 79.93±10.43 µm, respectively (P=0.02). Choroidal thickness was 377.69±50.77 µm for patients and 310.93±95.13 µm for controls (P=0.03). Conclusions: Even though celiac disease is primarily a disease of small intestine, this study demonstrated that the disorder can affect the eye as an extra intestinal involvement. Keywords: Celiac disease; optical coherence tomography; choroidal thickness; retinal nerve fiber layer thickness oranı ve çukurluk hacmı gibi optik sinir başı parametreleri ve ayrıca yüzeysel/derin foveal damarsız bölge alanı, koroid kalınlığı ve merkezi kornea kalınlığı swept-source optik koherens tomografi cihazı yardımıyla ölçüldü. Bulgular: Bütün ölçüm sonuçları arasında hastalardaki nasal kadran retina sinir lifi ve fovea altı koroid kontrol grubundan anlamlı derecede daha kalındı. Hastaların ve kontrollerin nasal kadran retina sinir lifi tabakası kalınlığı sırasıyla 91.62±15.27 µm ve 79.93±10.43 µm idi (P=0.02). Hastalar için koroid kalınlığı 377.69±50.77 µm, kontroller için 310.93±95 µm idi (P=0.03). Sonuç: Çölyak, öncelikli olarak bir ince bağırsak hastalığı olsa da bu çalışma hastalığın bağırsak dışı bir tutulum yeri olarak gözü de etkileyebileceğini göstermiştir. Anahtar sözcükler: Çölyak hastalığı, optik koherens tomografi, koroid kalınlığı, retina sinir lifi tabakası kalınlığı.

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Primary Sjögren’s syndrome in patients with celiac disease

Cited by 11 publications

References 25 publications

Pachychoroid Pigment Epitheliopathy and Choroidal Thickness Changes in Coeliac Disease

Pachychoroid Pigment Epitheliopathy and Choroidal Thickness Changes in Coeliac Disease

Celiac disease and Sjögren’s syndrome: A case report and review of literature

Ocular Parameters Quantified by the Swept-Source Optical Coherence Tomography in Celiac Disease / Çölyak Hastalığında Swept-Source Optik Koherens Tomografi ile Ölçülen Oküler Parametreler

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