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Gut. Oct 2001; 49(4): 502–505.
PMCID: PMC1728461

Duration of gluten exposure in adult coeliac disease does not correlate with the risk for autoimmune disorders


BACKGROUND AND AIMS—Duration of gluten exposure seems to predispose adolescents with coeliac disease to autoimmune diseases. In a retrospective cohort study, we assessed the relationship between autoimmune disorders and actual gluten exposure in patients in whom coeliac disease was diagnosed in adult life ([gt-or-equal, slanted]16 years).
METHODS—We screened for the presence of autoimmunity in 605 controls (16-84 years) and 422 patients (16-84 years), all of whom had been on gluten withdrawal for at least one year (median follow up 9.5 years). A logistic regression analysis, setting the prevalence of autoimmunity as the dependent variable, was employed to control for independent covariates as predictors of the risk of autoimmunity.
RESULTS—The prevalence of autoimmunity was threefold higher (p<0.00001) in patients than in controls. Mean duration of gluten exposure was 31.2 and 32.6 years for patients with or without autoimmunity. Logistic regression showed that increased age at diagnosis of coeliac disease was related to the prevalence of autoimmune disease while "actual gluten exposure" which takes into account diet compliance, follow up, and age at diagnosis of autoimmune disorders were not predictive for the risk of developing autoimmune diseases (odds ratio 0.82 per year).
CONCLUSION—The prevalence of autoimmune diseases in patients with a late coeliac disease diagnosis does not correlate with duration of gluten intake. Early exposure to gluten may modify the immunological response. Gluten withdrawal does not protect patients with a late diagnosis from autoimmune diseases.

Keywords: coeliac disease; autoimmune disorders; prevalence

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Selected References

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  • Feighery C. Fortnightly review: coeliac disease. BMJ. 1999 Jul 24;319(7204):236–239. [PMC free article] [PubMed]
  • Dieterich W, Ehnis T, Bauer M, Donner P, Volta U, Riecken EO, Schuppan D. Identification of tissue transglutaminase as the autoantigen of celiac disease. Nat Med. 1997 Jul;3(7):797–801. [PubMed]
  • Ventura A, Magazzù G, Greco L. Duration of exposure to gluten and risk for autoimmune disorders in patients with celiac disease. SIGEP Study Group for Autoimmune Disorders in Celiac Disease. Gastroenterology. 1999 Aug;117(2):297–303. [PubMed]
  • Sategna-Guidetti C, Volta U, Ciacci C, Usai P, Carlino A, De Franceschi L, Camera A, Pelli A, Brossa C. Prevalence of thyroid disorders in untreated adult celiac disease patients and effect of gluten withdrawal: an Italian multicenter study. Am J Gastroenterol. 2001 Mar;96(3):751–757. [PubMed]
  • Ferreira M, Davies SL, Butler M, Scott D, Clark M, Kumar P. Endomysial antibody: is it the best screening test for coeliac disease? Gut. 1992 Dec;33(12):1633–1637. [PMC free article] [PubMed]
  • Reunala T. Dermatitis herpetiformis: coeliac disease of the skin. Ann Med. 1998 Oct;30(5):416–418. [PubMed]
  • Collin P, Reunala T, Pukkala E, Laippala P, Keyriläinen O, Pasternack A. Coeliac disease--associated disorders and survival. Gut. 1994 Sep;35(9):1215–1218. [PMC free article] [PubMed]
  • Collin P, Mäki M. Associated disorders in coeliac disease: clinical aspects. Scand J Gastroenterol. 1994 Sep;29(9):769–775. [PubMed]
  • Sategna-Guidetti C, Grosso S, Pulitanó R, Benaduce E, Dani F, Carta Q. Celiac disease and insulin-dependent diabetes mellitus. Screening in an adult population. Dig Dis Sci. 1994 Aug;39(8):1633–1637. [PubMed]
  • Sategna-Guidetti C, Bruno M, Mazza E, Carlino A, Predebon S, Tagliabue M, Brossa C. Autoimmune thyroid diseases and coeliac disease. Eur J Gastroenterol Hepatol. 1998 Nov;10(11):927–931. [PubMed]
  • Kingham JG, Parker DR. The association between primary biliary cirrhosis and coeliac disease: a study of relative prevalences. Gut. 1998 Jan;42(1):120–122. [PMC free article] [PubMed]
  • Iltanen S, Collin P, Korpela M, Holm K, Partanen J, Polvi A, Mäki M. Celiac disease and markers of celiac disease latency in patients with primary Sjögren's syndrome. Am J Gastroenterol. 1999 Apr;94(4):1042–1046. [PubMed]
  • Mäki M, Collin P. Coeliac disease. Lancet. 1997 Jun 14;349(9067):1755–1759. [PubMed]
  • Strobel S. Mechanisms in adverse reactions to food. Mechanisms of tolerance and sensitization in the intestine and other organs of the body. Allergy. 1995;50(20 Suppl):18–25. [PubMed]
  • Feighery C. Coeliac disease, auto-immunity and thyroid disease. Ital J Gastroenterol Hepatol. 1999 May;31(4):288–289. [PubMed]
  • Garioch JJ, Lewis HM, Sargent SA, Leonard JN, Fry L. 25 years' experience of a gluten-free diet in the treatment of dermatitis herpetiformis. Br J Dermatol. 1994 Oct;131(4):541–545. [PubMed]
  • Fornasieri A, Sinico RA, Maldifassi P, Bernasconi P, Vegni M, D'Amico G. IgA-antigliadin antibodies in IgA mesangial nephropathy (Berger's disease). Br Med J (Clin Res Ed) 1987 Jul 11;295(6590):78–80. [PMC free article] [PubMed]
  • Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369–371. [PubMed]
  • Jacobson DL, Gange SJ, Rose NR, Graham NM. Epidemiology and estimated population burden of selected autoimmune diseases in the United States. Clin Immunol Immunopathol. 1997 Sep;84(3):223–243. [PubMed]
  • Collin P, Mäki M. Associated disorders in coeliac disease: clinical aspects. Scand J Gastroenterol. 1994 Sep;29(9):769–775. [PubMed]
  • Gilhar A, Shalaginov R, Assy B, Serafimovich S, Kalish RS. Alopecia areata is a T-lymphocyte mediated autoimmune disease: lesional human T-lymphocytes transfer alopecia areata to human skin grafts on SCID mice. J Investig Dermatol Symp Proc. 1999 Dec;4(3):207–210. [PubMed]
  • Ortonne JP. Recent developments in the understanding of the pathogenesis of psoriasis. Br J Dermatol. 1999 Apr;140 (Suppl 54):1–7. [PubMed]
  • Michaëlsson G, Gerdén B, Hagforsen E, Nilsson B, Pihl-Lundin I, Kraaz W, Hjelmquist G, Löf L. Psoriasis patients with antibodies to gliadin can be improved by a gluten-free diet. Br J Dermatol. 2000 Jan;142(1):44–51. [PubMed]

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