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Autoimmune disease has a high prevalence in celiacs.  The following study
concludes that the duration of gluten exposure in celiacs is not a
significant factor in the risk of developing autoimmune disease.  One
diagnosed late in life with celiac disease does not appear to be at greater
risk for developing autoimmune disease.  This seems counter-intuitive, but
there may be a good explanation for this result.

Studies in the UK and Italy have demonstrated that the prevalence of celiac
disease in young children is essentially the same as in adults, meaning
celiac disease begins in infancy.  Infancy is the critical time period for
the development of the immune system.  Gluten exposure and the onset of
celiac disease symptoms early in life, therefore, have a much greater and
more important impact on the immune system and its development than
exposure to gluten later in life.  Malabsorption during infancy and early
childhood can also adversely affect the crucial function of the thymus, T
cell production, and T cell repertoire.  So the stage is set early in life
rather than later for increased risk of autoimmune disease.  The timing of
gluten exposure in life seems to be more critical to autoimmune disease
risk rather than the overall lifetime duration of gluten exposure.  It is,
therefore, extremely important to diagnose celiac disease and initiate a
gluten-free diet as soon as possible during infancy and young childhood to
lower the risk of autoimmune disease later in life.

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Scand J Gastroenterol. 2005 Apr;40(4):437-43.

Coeliac disease, autoimmune diseases and gluten exposure.

Viljamaa M, Kaukinen K, Huhtala H, Kyronpalo S, Rasmussen M, Collin P.

Department of Internal Medicine, Tampere University Hospital, Finland.

OBJECTIVE: Gluten-free diet treatment has been proposed to prevent the
development of autoimmune diseases in coeliac subjects. The aim here was to
investigate the occurrence of autoimmune disorders in relation to gluten
intake in coeliac patients in a well-defined area. MATERIAL AND METHODS:
The frequency of autoimmune disorders was evaluated in 703 adults and
children with coeliac disease and in 299 controls with normal duodenal
histology. Incidence figures were given per 10,000 person-years. In
logistic regression analysis, where the prevalence of autoimmune disorders
was a dependent variable, the effect of age at end of follow-up, age at
diagnosis of coeliac disease, actual gluten exposure time, gender and
diagnostic delay were assessed. RESULTS: The prevalence of autoimmune
diseases was significantly higher in coeliac subjects than in controls. In
logistic regression analysis, age at end of follow-up, age at diagnosis of
coeliac disease and female gender increased the risk of autoimmune
disorders, whereas actual gluten exposure time reduced the risk; diagnostic
delay had no effect. A similar, though not statistically significant, trend
was seen in childhood coeliac disease to that in the whole study group.
CONCLUSIONS: Despite that fact that patients with coeliac disease are at
increased risk of various autoimmune conditions, the duration of gluten
exposure seems not to be of crucial importance in the development of
autoimmune diseases.

PMID: 16028438 [PubMed - in process]

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