Soltani Zahra, Baghdadi Azarakhsh, Nejadhosseinian Mohammad, Faezi Seyedeh Tahereh, Shahbazkhani Bijan, Mousavi Seyed Ali, Kazemi Kiarash
Rheumatology Research Center, Tehran University of Medical Sciences, Iran.
Department of Gastroenterology and Liver Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Iran.
Reumatologia. 2021;59(2):85-89. doi: 10.5114/reum.2021.105416. Epub 2021 Apr 27.
Celiac disease (CD) is one of the most common chronic diseases. Celiac disease has been associated with several autoimmune disorders, but the association with systemic lupus erythematosus (SLE) as a systemic autoimmune disease is still controversial. In this study, we aimed to determine the prevalence of biopsy-proven CD in patients with SLE, and to determine the clinical symptoms and laboratory data in these patients.
In a cross-sectional study, SLE patients at a referral clinic were evaluated for gastrointestinal symptoms between March and December 2016. Patients were evaluated by a gastroenterologist, and upper gastrointestinal endoscopy with intestinal biopsy was performed if deemed necessary. The clinical symptoms, laboratory data, and endoscopy results were recorded and compared between groups.
In total, 130 patients were evaluated in this study. Gastrointestinal symptoms were present in 40% of the patients. Endoscopy was performed in all SLE patients with gastrointestinal symptoms. Four patients (3%) were diagnosed as having CD based on biopsy results and response to a gluten-free diet. Anti-endomysium antibody (AEA) was found to be 100% sensitive and 99.2% specific for the diagnosis of CD in SLE patients, and anti-gliadin antibody (AGA) had a 50% sensitivity and 98% specificity. Patients with comorbid CD and SLE were significantly more likely to have diarrhea, abdominal pain, nausea/vomiting, recurrent oral aphthosis, and anemia.
The results of this study suggest that a significant association is present between CD and SLE. We found a prevalence of 3% for biopsy-proven CD in patients with SLE, which is five times the prevalence of CD in the general population.
乳糜泻（CD）是最常见的慢性病之一。乳糜泻与多种自身免疫性疾病相关，但与系统性红斑狼疮（SLE）这种系统性自身免疫性疾病的关联仍存在争议。在本研究中，我们旨在确定经活检证实的CD在SLE患者中的患病率，并确定这些患者的临床症状和实验室数据。
在一项横断面研究中，对2016年3月至12月在一家转诊诊所的SLE患者进行胃肠道症状评估。由胃肠病学家对患者进行评估，必要时进行上消化道内镜检查及肠道活检。记录并比较各组的临床症状、实验室数据及内镜检查结果。
本研究共评估了130例患者。40%的患者有胃肠道症状。所有有胃肠道症状的SLE患者均接受了内镜检查。根据活检结果及对无麸质饮食的反应，4例患者（3%）被诊断为患有CD。抗肌内膜抗体（AEA）对SLE患者CD诊断的敏感性为100%，特异性为99.2%，抗麦醇溶蛋白抗体（AGA）的敏感性为50%，特异性为98%。合并CD和SLE的患者更易出现腹泻、腹痛、恶心/呕吐、复发性口腔溃疡和贫血。
本研究结果提示CD与SLE之间存在显著关联。我们发现经活检证实的CD在SLE患者中的患病率为3%，是普通人群中CD患病率的5倍。
