Low prevalence of coeliac disease in patients with systemic sclerosis: a cross-sectional study of a registry cohort

Forbess, Lindsy; Gordon, Jessica; Doobay, Kamini; Bosworth, Brian; Lyman, Stephen; Davids, Morgana L.; Spiera, Robert

doi:10.1093/rheumatology/kes390

Cited by 16 publications

(8 citation statements)

References 16 publications

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“…Autoantibody screening revealed anti‐tissue transglutaminase antibody. Three prior studies also revealed that coeliac disease is more frequent in SSc patients than in the general population (4–8% vs. 1%); most of their SSc patients had asymptomatic coeliac disease . Altogether, because coeliac disease is associated with increased risk of lymphoma, our findings suggest that coeliac antibody screening tests (anti‐tissue transglutaminase antibody) may be useful for disclosing coeliac disease at early stage in patients with SSc.…”

Section: Discussionsupporting

confidence: 62%

Gastrointestinal mucosal abnormalities using videocapsule endoscopy in systemic sclerosis

Marie

Antonietti

Houivet

et al. 2014

Aliment Pharmacol Ther

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Section: Discussionsupporting

confidence: 62%

Gastrointestinal mucosal abnormalities using videocapsule endoscopy in systemic sclerosis

Marie

Antonietti

Houivet

et al. 2014

Aliment Pharmacol Ther

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“…These two studies were limited by small sample sizes (n=30 and n=50) [ 15 , 16 ]. The third study, conducted by Forbess et al , tested 72 SSc patients for celiac disease serology then biopsy [ 17 ]. They reported the prevalence of celiac antibodies in SSc population as 3/72 (4%), but no cases of celiac disease confirmed by biopsy were seen in their SSc cohort [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…The third study, conducted by Forbess et al , tested 72 SSc patients for celiac disease serology then biopsy [ 17 ]. They reported the prevalence of celiac antibodies in SSc population as 3/72 (4%), but no cases of celiac disease confirmed by biopsy were seen in their SSc cohort [ 17 ]. They also found no important differences with respect to GI symptoms in the celiac antibody-positive compared with antibody-negative SSc patients.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal manifestations associated with systemic sclerosis: results from the nationwide inpatient sample

Alastal

Hammad

Renno

et al. 2017

aog

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BackgroundSystemic sclerosis (SSc) is a multisystem disease associated with significant morbidity and increased mortality. The prevalence of different gastrointestinal (GI) manifestations has been investigated in multiple, but mainly small, retrospective studies. In this study, we investigated the prevalence and risk for a broad spectrum of GI disorders and malignancies in a large sample of inpatients with SSc in the United States.MethodsWe conducted a retrospective analysis using the 2010-2011 Healthcare Cost and Utilization Project – Nationwide Inpatient Sample (HCUP-NIS). SSc patients were identified by ICD-9-CM code 710.1. Non-SSc patients (“controls”) were matched to cases 4:1 by age and sex. We examined demographics, clinical characteristics, and a range of GI conditions.ResultsFrom 15,824,031 total patients, 13,633 cases of SSc were matched to 54,532 controls. The prevalence of GI manifestations among SSc patients was 59.24% compared to 29.96% for controls (P<0.0001). Significantly elevated GI manifestations in SSc patients included dysphagia (4.3% vs. 1.9%, P<0.0001), esophageal reflux (34.8% vs. 15.4%, P<0.0001), Barrett’s esophagus (1.7% vs. 0.3%, P<0.0001), constipation (6% vs. 4.6%, P<0.0001), diarrhea (4.5% vs. 2.4%, P<0.0001), fecal incontinence (0.4% vs. 0.2%, P<0.0001), and celiac disease (0.2% vs. 0%, P<0.0001). Some GI disorders were significantly lower in SSc patients, including cholelithiasis (1.6% vs. 2.1%, P<0.0001) and GI malignancies (1% vs. 2.2%, P<0.0001).ConclusionsOur results emphasize the established association between SSc and esophageal disorders, such as dysphagia and reflux disease. Our analysis indicated a significant positive association between SSc and celiac disease, and a negative association between SSC and cholelithiasis.

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“…Os resultados da literatura quanto à prevalência da doença celíaca (DC) na ES têmse mostrado algo controversos. Dois estudos diferentes acharam uma prevalência de aproximadamente 8% de DC na ES, enquanto que num estudo retrospectivo, Forbess et al 17 estudou a prevalência da doença celíaca em doentes com ES, associando sintomatologia gastrointestinal com os autoanticorpos característicos da doença celíaca (Ac anti-transglutaminasa, anti-gliadina e anti-endomíssio), não se tendo verificado diferenças em relação ao grupo controlo, defendendo que o rastreio desta patologia não está indicado nos doentes com ES 17 .…”

Section: Estômagounclassified

Envolvimento Gastrointestinal na Esclerose Sistémica

Real¹,

Adelino²,

Lopes³

et al. 2018

Gal. Clin.

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REVISIÓN invasivo validado na doença inflamatória intestinal, no entanto, estudo recentes apresentam a FC como um possível biomarcador de doença GI em doentes com ES 8,9. Em 2 estudos semelhantes levados a cabo por Andréasson et al. 8,9 , a FC encontra-se elevada em doentes com ES e patologia GI, pelo que é um biomarcador promissor da doença gastrointestinal na ES 8,9. Num estudo prospectivo com 99 doentes com ES, Savarino et al. 10 , observou que o esófago é o órgão mais frequentemente afetado, seguindo-se o intestino delgado e o estômago 10. Num estudo multicêntrico com 54 doentes com ES, 54% apresentavam transtornos gastrointestinais, onde as lesões potencialmente sangrantes predominavam: ectasia vascular antral gástrica (GAVE)-34.6%, telangiectasias gástricas ou do intestino delgado (26.9%) e angiodisplasia gástrica ou do intestino delgado (38.5%). Este estudo mostrou uma forte correlação entre lesões vasculares gastrointestinais e a vasculopatia extra sistema digestivo (p. ex. úlceras digitais) 11. Contudo, a mortalidade relacionada com o sistema GI é baixa (6-12%), no entanto tem um grande impacto na qualidade da vida diária e acarreta importantes comorbilidades o que, subsequentemente, afecta a sobrevida dos doente 2. O envolvimento GI severo afecta apenas 8% dos doentes com ES, no entanto quando presente a mortalidade é elevada, com apenas 15% de sobrevida aos 9 anos 3. O envolvimento GI ocorre em ambos subtipos (difusa e limitada), sendo importante ter em consideração, que a severidade cutânea e GI podem não estar correlacionadas 2. Os doentes com ES, com pouca ou nenhuma afectação da pele, podem apresentar dismotilidade gastrointestinal, assim como os que apresentam afectação cutânea severa, podem não apresentar qualquer sintomatologia GI 6. Neste artigo, faz-se uma revisão do envolvimento individual de cada órgão do tubo digestivo (cavidade oral, esófago, estômago, fígado e vias biliares, pâncreas, intestino delgado e grosso, recto e ânus).

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Low prevalence of coeliac disease in patients with systemic sclerosis: a cross-sectional study of a registry cohort

Abstract: Contrary to the only two previously published studies, the low prevalence of CD that we found does not suggest that concurrent CD is a common cause of gastrointestinal complaints in SSc patients.

Cited by 16 publications

References 16 publications

Gastrointestinal mucosal abnormalities using videocapsule endoscopy in systemic sclerosis

Gastrointestinal mucosal abnormalities using videocapsule endoscopy in systemic sclerosis

Gastrointestinal manifestations associated with systemic sclerosis: results from the nationwide inpatient sample

Envolvimento Gastrointestinal na Esclerose Sistémica

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