Patients with psoriasis often have increased serum levels of IgA antibodies to gliadin

Michaëlsson, G; Gerdén, Barbro; Ottosson, M; Parra, Antonio; Sjöberg, Olof; Hjelmquist, G.; Lööf, Lars

doi:10.1111/j.1365-2133.1993.tb03329.x

Cited by 89 publications

(79 citation statements)

References 9 publications

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“…A link between psoriasis and CD was proposed by early studies [27,28,29,30] and controverted by others [31]. The prevalence of CD increases 2-4-fold in the population with psoriasis.…”

Section: Mucocutaneous Manifestations Of CDmentioning

confidence: 99%

Extraintestinal Manifestations of Celiac Disease

Pinto-Sanchez¹,

Berčík²,

Verdú³

et al. 2015

Dig Dis

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Case finding for celiac disease (CD) is becoming increasingly common practice and is conducted in a wide range of clinical situations ranging from the presence of gastrointestinal symptoms to failure to thrive in children, prolonged fatigue, unexpected weight loss and anemia. Case finding is also performed in associated conditions, such as autoimmune thyroid disease, dermatitis herpetiformis and type 1 diabetes, as well as in patients with irritable bowel syndrome, unexplained neuropsychiatric disorders and first-degree relatives of patients with diagnosed CD. This aggressive active case finding has dramatically changed the clinical characteristics of newly diagnosed patients. For instance, higher numbers of patients who present with extraintestinal symptoms are now being diagnosed with CD. Current recommendations state that due to a high risk for complications if the disease remains undiagnosed, patients with extraintestinal symptoms due to CD require appropriate diagnosis and treatment. Despite criticism regarding the cost-effectiveness of case finding in CD, such an aggressive approach has been considered cost-effective for high-risk patients. The diagnosis of CD among patients with extraintestinal symptoms requires a high degree of awareness of the clinical conditions that carry a high risk for underlying CD. Also, understanding the correct use of specific serology and duodenal histology is key for an appropriate diagnostic approach. Both procedures combined are able to confirm diagnosis in the vast majority of cases. However, in certain circumstances, serology and even duodenal histology cannot confirm or rule out CD. A common cause of negative IgA serology is IgA deficiency. For such eventuality, IgG-based serological tests can help confirm the diagnosis. Importantly, some histologically diagnosed cases still remain seronegative despite exclusion of IgA deficiency. On the other hand, duodenal histology may be normal despite the presence of CD-specific antibodies and active CD. This has been clearly demonstrated in some cases of untreated dermatitis herpetiformis, but may also be due to the patchy condition of CD or lesions that are not adequately recognized by nonexpert endoscopists and/or pathologists. The effectiveness of agluten-free diet depends on the clinical end point addressed. A good example is the outcome of bone loss. While risk for fracture normalizes after the first year of dietary treatment, bone parameters measured by densitometry may not be normalized in the long-term follow-up. Moreover, it is still unclear how far an early gluten-free diet will positively affect associated autoimmune diseases like type 1 diabetes and autoimmune thyroiditis.

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“…A link between psoriasis and CD was proposed by early studies [27,28,29,30] and controverted by others [31]. The prevalence of CD increases 2-4-fold in the population with psoriasis.…”

Section: Mucocutaneous Manifestations Of CDmentioning

confidence: 99%

Extraintestinal Manifestations of Celiac Disease

Pinto-Sanchez¹,

Berčík²,

Verdú³

et al. 2015

Dig Dis

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“…El cálculo del tamaño de la muestra se realizó considerando una prevalencia estimada de 10% (p =0,1) de la asociación entre enfermedad celíaca y psoriasis 16,17,19 , con un nivel de confianza de 95% y un tamaño máximo de error de 4%, lo que dio una cifra de 79 casos.…”

Section: Pacientes Y Métodosunclassified

“…En nuestra serie, sólo 6 pacientes tuvieron AGA positivo (6/26), por debajo de lo encontrado en estudios de Michaelsson y cols 16 ; sin embargo, nuestras cifras están de acuerdo con otras publicaciones 18,19 (Tabla 4).…”

Section: N V E S T I G a C I ó Nunclassified

“…Finalmente, la prevalencia de EC en pacientes psoriáticos observada en los distintos estudios va desde 0,7% 31 hasta 4,4% 17 . En relación a la positividad de marcadores de EC, ésta podría llegar a ser tan alta como 16% 16 , pero ese solo hecho no es diagnóstico de EC, ya que puede ser un resultado inespecífico. Se ha reportado AGA positivo en diversas patologías no EC, tales como nefritis por IgA, anemia de células falciformes, artritis reumatoide juvenil, tiroiditis autoinmune, espondilitis anquilosante, múltiples enfermedades psiquiátricas, neurológicas y también en voluntarios sanos [36][37][38] .…”

Section: N V E S T I G a C I ó Nunclassified

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Estudio de enfermedad celíaca en pacientes con psoriasis

et al. 2007

Rev. méd. Chile

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“…This obser vation lends support for the supposition that an increase in serum IgA might be an antipsoriatic mechanism, stabilizing the psoriatic process. However, although neutrophil chemo taxis inhibiting activity of sera from patients with psoriasis has been shown to depend upon IgA polymeric forms in vitro, it is not clear whether this is important in vivo [19], Different groups have reported that serum IgA levels are increased in psoriasis [8,[20][21][22][23][24], Circulating IgA immune complexes have also been reported to be increased in psori asis [9,25]. Guilhou et al |8| reported that the increase in IgA is specific for psoriasis as no patient with eczema had such an increase.…”

Section: Discussionmentioning

confidence: 99%