Coeliac Disease With Rheumatoid Arthritis: An Unusual Association

Warjri, Synrang Batngen; Ete, Tony; Beyong, Taso; Barman, Bhupen; Lynrah, Kyrshanlang G; Nobin, Hage; Perme, Obang

doi:10.14740/gr641w

Cited by 10 publications

(9 citation statements)

References 9 publications

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“…While RA-related autoantibodies may be generated in the joints in individuals with established disease, medical data suggests that mucosal sites may be the initial site of production. One of the autoimmune disorders with similar pathology to that seen in RA is CD and several studies have shown co-occurrence of the two disorders [5,8]. In our study, 35% (16/45) of patients with CD were found to have positive RA serology which included fifteen patients with positive RF (33%) and three with positive anti-CCP antibodies (6.6%).…”

Section: Discussionsupporting

confidence: 50%

“…The above stated hypothesis is also strengthened by the medical literature documenting the co-occurrence of RA with various other autoimmune diseases-one of which is Celiac disease (CD) [5]. This RA-CD relationship is especially important because it has been postulated that immune dysfunction in RA arises from the intestinal mucosa and the increased intestinal permeability in CD leads to protein citrullination with subsequent autoantibody production in RA.…”

Section: Introductionmentioning

confidence: 98%

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‘Preclinical’ rheumatoid arthritis in patients with celiac disease: A cross-sectional study

Fayyaz

Gunawan²,

Rehman³

2019

Journal of Community Hospital Internal Medicine Perspectives

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Objective: Preclinical or latent RA is characterized by the presence of autoantibodies in the absence of clinical symptoms. The objective of this study was to identify the prevalence of preclinical RA in patients with Celiac disease in order to determine whether or not such individuals should be screened for RA based on the high-risk. Method: A cross-sectional study was carried out on patients with celiac disease in a tertiary care center in Rawalpindi, Pakistan. After initial assessment, RA-autoantibody levels (Rheumatoid factor and anti-CCP) were checked. Descriptive analysis was performed on the data gathered. Results: Sixteen patients with known celiac disease were identified to have positive rheumatoid factor and/or anti-CCP levels with an overall prevalence rate of 35%. This trend was significant for celiac patients having history of inflammatory arthritis and active celiac disease. No statistical significance was seen in baseline characteristics for categories of patients with positive rheumatoid factor versus with positive anti-CCP antibodies. Conclusion: Patients with CD can be considered as a high-risk group based on the high prevalence rate of rheumatoid factor/anti-CCP positivity observed in this study and should be considered for further RA screening/preventive studies.Abbreviations: RA = Rheumatoid arthritis; CD = Celiac disease; anti-CCP = anti-citrullinated cyclic peptide) antibodies; RF = Rheumatoid factor; GFD = Gluten-free diet ARTICLE HISTORY

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Section: Discussionsupporting

confidence: 50%

Section: Introductionmentioning

confidence: 98%

‘Preclinical’ rheumatoid arthritis in patients with celiac disease: A cross-sectional study

Fayyaz

Gunawan²,

Rehman³

2019

Journal of Community Hospital Internal Medicine Perspectives

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“…Gluten, a complex mixture of hundreds of distinct proteins present in wheat grains, mainly gliadin and glutenin, triggers immunological response mainly in coeliac disease. Recent studies suggest that gluten may represent an antigen also in RA, driving an altered immune response [179]. In RA patients, a study showed that a gluten-free, vegan diet followed for 1 year was associated with a significant decrease of anti-beta-lactoglobulin and anti-gliadin antibodies levels, as well as a decrease of disease activity [180].…”

Section: Glutenmentioning

confidence: 99%

Dietary Habits and Nutrition in Rheumatoid Arthritis: Can Diet Influence Disease Development and Clinical Manifestations?

et al. 2020

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Rheumatoid arthritis (RA) is a systemic, autoimmune disease characterized by joint involvement, with progressive cartilage and bone destruction. Genetic and environmental factors determine RA susceptibility. In recent years, an increasing number of studies suggested that diet has a central role in disease risk and progression. Several nutrients, such as polyunsaturated fatty acids, present anti-inflammatory and antioxidant properties, featuring a protective role for RA development, while others such as red meat and salt have a harmful effect. Gut microbiota alteration and body composition modifications are indirect mechanisms of how diet influences RA onset and progression. Possible protective effects of some dietary patterns and supplements, such as the Mediterranean Diet (MD), vitamin D and probiotics, could be a possible future adjunctive therapy to standard RA treatment. Therefore, a healthy lifestyle and nutrition have to be encouraged in patients with RA.

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“…Gut-derived antigens are the key initiators and drivers of dysimmunity in RA. These shared immunological mechanisms explain the concomitant occurrence of celiac disease and RA [ 29 ]. Gluten-free diet has been associated with benefits in patients with RA though the existing evidence is inconclusive.…”

Section: Diet In Ramentioning

confidence: 99%

Role of Diet in Influencing Rheumatoid Arthritis Disease Activity

Badsha

2018

TORJ

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Background:Patients with Rheumatoid Arthritis (RA) frequently ask their doctors about which diets to follow, and even in the absence of advice from their physicians, many patients are undertaking various dietary interventions.Discussion:However, the role of dietary modifications in RA is not well understood. Several studies have tried to address these gaps in our understanding. Intestinal microbial modifications are being studied for the prevention and management of RA. Some benefits of vegan diet may be explained by antioxidant constituents, lactobacilli and fibre, and by potential changes in intestinal flora. Similarly, Mediterranean diet shows anti-inflammatory effects due to protective properties of omega-3 polyunsaturated fatty acids and vitamins, but also by influencing the gut microbiome. Gluten-free and elemental diets have been associated with some benefits in RA though the existing evidence is limited. Long-term intake of fish and other sources of long-chain polyunsaturated fatty acids are protective for development of RA. The benefits of fasting, anti-oxidant supplementation, flavanoids, and probiotics in RA are not clear. Vitamin D has been shown to influence autoimmunity and specifically decrease RA disease activity. The role of supplements such as fish oils and vitamin D should be explored in future trials to gain new insights in disease pathogenesis and develop RA-specific dietary recommendations.Conclusion:Specifically more research is needed to explore the association of diet and the gut microbiome and how this can influence RA disease activity.

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Coeliac Disease With Rheumatoid Arthritis: An Unusual Association

Cited by 10 publications

References 9 publications

‘Preclinical’ rheumatoid arthritis in patients with celiac disease: A cross-sectional study

‘Preclinical’ rheumatoid arthritis in patients with celiac disease: A cross-sectional study

Dietary Habits and Nutrition in Rheumatoid Arthritis: Can Diet Influence Disease Development and Clinical Manifestations?

Role of Diet in Influencing Rheumatoid Arthritis Disease Activity

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