<<Disclaimer: Verify this information before applying it to your situation.>> Rensch M, 2001. The Prevalence of Celiac Disease Autoantibodies in Patients With Systemic Lupus Erythematosus, Amer. Jour. of Gastro 96: 1113-1115. Recognizing that systemic lupus erythematosus (SLE) patients have false positive autoantibodies for primary biliary cirrhosis, chronic active hepatitis, Sjogren’s syndrome, thyroid disorders, rheumatoid arthritis, and other diseases, this study sought to identify and determine the prevalence of CD autoantibodies in SLE patients. Also, CD and SLE patients share common (genetic) HLAs, B-8, DR2 and DR3. Results: Twenty-four or 23% of SLE patients tested positive for the anti-gliadin antibody (AGA) but none of them including the remaining 79 SLE patients tested positive for the anti-endomysial antibody (EmA). However, none of the 24 patients positive for AGA had positive biopsies according to international criteria, assuming characteristic villous atrophy. Therefore, the researchers concluded that the false-positive rate of the AGA was 23%, representing the 24 who tested positive for AGA but not EmA nor biopsy confirmation (in other words, the specificity of the AGA is 77% for the diagnosis of CD in SLE patients). Also, despite the expectation that a higher prevalence of CD would be found in SLE patients because they share increased or common HLAs, the data found no specific association with CD beyond that of the general population prevalence which at the time of this study was approx. 0.1-0.5%. Comments: The drawback to this study is that it does not follow-up the AGA-positive SLE patients. That is, negative biopsies do not necessarily exclude CD as a possible diagnosis. In recent studies, CD has been been found in patients without villous atrophy or mild intestinal damage (subclinical and silent forms of CD) and that patients with milder intestinal damage often are not detected by blood antibody screenings. The expression of gluten-sensitive patients has been found in patients even with normal intestinal villi. What may have been the results if the researchers studied the biopsies for an increased lymphocyte count as an indicator of gluten-sensitivity? What about a trial of a gluten-free diet to determine if there is some symptom remission? What would be the results of a larger prevalence study since this study only included a total of 103 patients? There is no doubt that as the researchers cite- a larger study should be performed to determine the true prevalence of CD in SLE patients. _________________________________________________________________ Get MSN 8 Dial-up Internet Service FREE for one month. Limited time offer-- sign up now! http://join.msn.com/?page=dept/dialup * Please remember some posters may be WHEAT-FREE, but not GLUTEN-FREE *