Risk Factors for Polyautoimmunity among Patients with Celiac Disease: A Cross-Sectional Survey

Abstract

Aim: To define the prevalence of polyautoimmunity (PAI) among celiac disease (CD) patients and to compare clinical and laboratory features of CD patients with or without PAI in order to determine the risk factors for PAI in CD. Material and Method: Patients diagnosed with CD in our clinic between 2007 and 2014 with at least 1 year of follow-up were retrospectively evaluated. Totally 145 patients were included in the study. Information on patient demographics and laboratory data were obtained from patient records. The study participants were divided into 2 groups. Group 1 was the CD-alone group consisting of patients without any other autoimmune diseases (AIDs), while group 2 was the PAI group consisting of patients with accompanying one or more AIDs. Results: The mean age of 145 CD patients (106 female and 39 male) included in the study was 37.2 ± 12.3 years. Of the 145 patients included, 48 (33.1%) were in the PAI group. When two groups were compared with each other in terms of the demographic features and laboratory data, the following were identified as risk factors for PAI: female gender, family history for AIDs, antigliadin IgG positivity, vitamin D deficiency, antinuclear antibody positivity ≥1/80 titer and having any musculoskeletal disease. Conclusion: To the best of our knowledge, this is one of the largest studies in the literature on CD patients for the PAI prevalence and related risk factors. Identification of the risk factors in early stages is important to explore PAI among CD patients. Larger, prospective studies are warranted about the risk factors and autoimmune characteristics of CD.

Immune Mediated Diseases in Patients With Celiac Disease and Their Relatives: A Comparative Study of Age and Sex

“…Notable, young patients in the present study (Groups FI and MI) were diagnosed with IMDs before the diagnosis of CD, which is consistent with a report by Demirezer et al in Turkey (24) . Demirezer and colleagues identified female sex, family history of AIDs as risk factors for IMDs, as presented in the present study.…”

“…Interestingly, three or four IMDs occurring in the same patient is a rare association (29) . Compared with controls, patients with CD were 11.4 times more likely to develop Addison's disease before or after the diagnosis of CD (24) . In this study, one female (age, 49 years) and one male (age, 61 years) presented with Addison's disease at the diagnosis of CD.…”

Similarities and differences between older and young adult patients with celiac disease

“…studied 520 CD patients, and the most common AIDs seen in their study population were psoriasis, Hashimoto's thyroiditis and Sjögren's syndrome . Bolat et al investigated 145 CD patients by means of polyautoimmunity, and found that 33% of their patients had polyautoimmunity and 10.3% had multiple autoimmune syndrome . They also reported that female sex, family history of an AID, vitamin D deficiency, anti‐gliadin IgG positivity, antinuclear antibody positivity >1/80 titer and having a musculoskeletal disease were risk factors for polyautoimmunity.…”

Rheumatologic manifestations in celiac disease: what should we remember?

“…The relative risk of associating one or more autoimmune pathologies is approximately three times higher in CD patients when compared to general population [14] and 30% of the CD patients have also another immune pathology [15]. Together with the musculoskeletal involvement, the female gender, DGP positivity, vitamin D deficiency and antinuclear antibody positivity were associated with polyautoimmunity in CD patients [15]. The following mechanisms might explain the increased autoimmunity expression in CD: similar genetic features, common triggers, or the disturbed intestinal permeability [16].…”