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What is Gluten and Dairy Intolerance? What is the difference between an allergy and intolerance/sensitivity. Latest medical research. Open to the public.
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TOPIC: Gluten Sensitivity Masquerading as SLE Lupus

Gluten Sensitivity Masquerading as SLE Lupus 09 Nov 2008 22:45 #552

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Ann Rheum Dis. 2004 Nov;63(11):1501-3.

Gluten sensitivity masquerading as systemic lupus erythematosus.

Hadjivassiliou M , Sanders DS , Grünewald RA , Akil M .

Department of Neurology, The Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK. This email address is being protected from spambots. You need JavaScript enabled to view it.

CASE REPORTS: Three patients are described whose original presentation and immunological profile led to the erroneous diagnosis of systemic lupus erythematosus. The correct diagnosis of gluten sensitivity was made after years of treatment with steroids and other immunosuppressive drugs.

CONCLUSIONS: The immunological profile of IgA deficiency and/or raised double stranded DNA in the absence of antinuclear factor together with raised inflammatory markers and symptoms suggestive of an immune diathesis should alert the physician to the possibility of gluten sensitivity. The presence of an enteropathy is no longer a prerequisite for the diagnosis of gluten sensitivity, which can solely present with extraintestinal symptoms and signs. Knowledge of the diverse manifestations of gluten sensitivity is essential in avoiding such misdiagnosis.

PMID: 15479903 [PubMed - indexed for MEDLINE]

Gluten Sensitivity Masquerading as SLE Lupus 14 Nov 2009 14:17 #553

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J Clin Gastroenterol. 2008 Mar;42(3):252-5.

Adult celiac disease followed by onset of systemic lupus erythematosus.
Freeman HJ .

Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, BC. This email address is being protected from spambots. You need JavaScript enabled to view it.


BACKGROUND: Celiac disease has been associated with autoimmune disease (eg, autoimmune thyroiditis) and the appearance of different autoantibodies (eg, antidouble-stranded DNA). Conversely, tissue transglutaminase antibodies have been detected in autoimmune disorders, including systemic lupus erythematosus (SLE), but cases of celiac disease with SLE have been only rarely recorded.

METHODS: In this study, 246 patients with biopsy-defined celiac disease were evaluated for a prior diagnosis of SLE on the basis of American Rheumatological Association-defined clinical and serologic parameters. RESULTS: There were 6 patients with celiac disease and SLE, or 2.4%, including 4 females and 2 males. Their mean age at diagnosis of celiac disease was 44.7 years and SLE 50 years. In all patients, the diagnosis of SLE was established from 2 years to more than 10 years after the diagnosis of celiac disease, with a mean of 5.3 years. The celiac disease in all 6 patients responded to a gluten-free diet with histologic normalization of the small intestinal biopsies. Despite this small bowel biopsy response, SLE appeared later in the clinical course of the celiac disease.

CONCLUSIONS: This study suggests that SLE occurs far more frequently in biopsy-defined celiac disease than is currently appreciated, and detection may be more likely if the period of clinical follow-up of the celiac disease is prolonged.

PMID: 18223501 [PubMed - indexed for MEDLINE]

Scand J Gastroenterol. 2009;44(2):168-71.

Gliadin IgG antibodies and circulating immune complexes.
Eisenmann A , Murr C , Fuchs D , Ledochowski M .

Department of Clinical Nutrition, Medical University of Innsbruck, Austria.


OBJECTIVE: Circulating immune complexes (CICs) in blood are associated with autoimmune-diseases such as systemic lupus erythematosus, immune complex glomerulonephritis, rheumatoid arthritis and vasculitis. However, slightly increased serum concentrations of such CICs are sometimes also found in healthy individuals. The objective of the current study was to assess whether food antigens could play a role in the formation of CICs. MATERIAL AND METHODS: A total of 352 (265 F, 87 M), so far, healthy individuals were tested for CICs containing C1q and immunoglobulin G (IgG) as well as for gliadin IgG antibodies using the ELISA technique. Additionally, fructose and lactose malabsorption was assessed using hydrogen breath tests.

RESULTS: In our study, 15.3% (54/352) of the patients presented with elevated CIC concentrations (above 50 microg/ml) and 6.5% (23/352) of the study population were positive for gliadin IgG antibodies (above 20 U/ml). CIC concentration levels were significantly higher in the group with elevated gliadin IgG antibodies (CIC median: 49.0 microg/ml) compared with the group with normal levels of gliadin IgG antibodies (CIC median: 30.0 microg/ml; Mann-Whitney U-test, U=1992; p <0.001). As expected, there was no difference in CIC concentrations (Mann-Whitney U-test, U=6106; p=0.783) and gliadin IgG (Mann-Whitney U-test, U=3761; p=0.411) between patients in the fructose or lactose malabsorber groups and the subjects without malabsorption.

CONCLUSIONS: The results of this study indicate that certain food antigens (e.g. gluten) could play a role in the formation of CICs. An association between CICs and fructose or lactose malabsorption seems to be improbable.

PMID: 18819035 [PubMed - indexed for MEDLINE]  

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