Contrary to previous reports, a new study of a group of patients with juvenile idiopathic arthritis found none with celiac disease. The investigators called for further research to better understand how these two diseases might be interconnected.
The study, “Serological screening for coeliac disease in patients with juvenile idiopathic arthritis,” was published in the Arab Journal of Gastroenterology.
Celiac disease is an autoimmune disease that affects between 0.5% and 1% of people. It is characterized by an intolerance to gluten, a protein found in some grains, particularly wheat.
Having other autoimmune diseases, such as type 1 diabetes, increases the likelihood of a person developing celiac disease. For this reason, people with JIA — an autoimmune disease — may be at increased risk of developing celiac disease.
Further supporting this idea, genetic variations in a particular region in chromosome 4 — called 4q27 — are associated with being susceptible to developing both celiac disease and JIA, as well as rheumatoid arthritis.
There have been a few case reports of children with both JIA and celiac disease, but there haven’t been many studies looking at the prevalence of celiac disease among people with JIA.
This may be of particular importance because some of the medications used to treat JIA can cause side effects similar to common symptoms of celiac disease, such as intestinal distress and lack of growth, so it’s possible that people with JIA who do have celiac disease aren’t diagnosed because their symptoms are assumed to be side effects.
Additionally, many celiac disease patients don’t experience obvious symptoms and can only be identified via a blood test.
To try to determine how frequently people with JIA develop celiac disease, researchers recruited 96 people with JIA at a center in Turkey, none of whom showed any obvious signs of celiac disease.
The researchers took blood samples and analyzed them for the presence of antibodies targeting a protein called tissue transglutaminase. Antibodies against this protein — which normally helps fix damage in the body’s tissues — are characteristic of celiac disease.
However, none of the patients tested positive for these antibodies — none had celiac disease.
This may suggest that people with JIA are unlikely to develop celiac disease, or that no relationship exists between the two diseases. However, such conclusions can’t really be drawn from this relatively small study.
Therefore, the researchers called for further, larger studies to more precisely understand whether and how the two diseases are related. “Long-term studies with more JIA patients are needed to provide more precise interpretation,” they said.
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