Primary biliary cirrhosis and autoimmune cholangitis are not associated with coeliac disease in Crete.
BACKGROUND
An increased prevalence of coeliac disease in patients with primary biliary cirrhosis has been recently reported. However, in other studies the association has not been confirmed. There have been no formal attempts to systematically evaluate patients with autoimmune cholangitis for coeliac disease.


METHODS
Sera from 62 patients with primary biliary cirrhosis, 17 with autoimmune cholangitis and 100 blood donors were screened for anti-gliadin, anti-endomysial, anti-reticulin, and IgA class antibodies to guinea pig liver-derived tissue transglutaminase. Eighteen untreated coeliacs served as methodological controls. Analyses were performed by using the chi2 and Fischer's exact tests.


RESULTS
Anti-gliadin antibodies were detected in 21% of patients with primary biliary cirrhosis, 35% of patients with autoimmune cholangitis, and 3% of controls (p < 0.001). IgA class gliadin antibodies positivity was more pronounced in patients with Scheuer's stage III-IV disease (p < 0.05). Anti-transglutaminase antibodies were detected in 10% and in 18% of patients with primary biliary cirrhosis and autoimmune cholangitis respectively (p < 0.001). Anti-reticulin and anti-endomysial antibodies were negative in all patients. Duodenal biopsies were performed in 59% and 71% of patients with primary biliary cirrhosis and autoimmune cholangitis respectively, tested positive for at least one antibody class. No histological features of coeliac disease were found.


CONCLUSIONS
We were unable to demonstrate an increased risk of coeliac disease in patients with primary biliary cirrhosis and autoimmune cholangitis. Our results confirm the previously reported high prevalence of false-positive anti-gliadin and guinea pig liver-derived anti-tissue transglutaminase antibodies in patients with chronic liver disease.
Chatzicostas
Costantinos
C
Department of Gastroenterology, University Hospital of Heraklion, PO Box 1352, Heraklion 71110, Crete, Greece. matrix01gr@yahoo.gr
Roussomoustakaki
Maria
M
Drygiannakis
Dimitrios
D
Niniraki
Maria
M
Tzardi
Maria
M
Koulentaki
Mary
M
Dimoulios
Philippos
P
Mouzas
Ioannis
I
Kouroumalis
Elias
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000150:complications* / Q000276:immunology; D002446:Celiac Disease / Q000209:etiology*; D002761:Cholangitis / Q000150:complications* / Q000276:immunology; D002908:Chronic Disease; D005189:False Positive Reactions; D005260:Female; D005903:Gliadin / Q000276:immunology; D006115:Greece; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D008105:Liver Cirrhosis, Biliary / Q000150:complications* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009218:Myosins / Q000276:immunology; D012155:Reticulin / Q000276:immunology; D011503:Transglutaminases / Q000276:immunology
D001323:Autoantibodies; D007070:Immunoglobulin A; D012155:Reticulin; D005903:Gliadin; D011503:Transglutaminases; D009218:Myosins