Allergy prevalence in adult celiac disease.
BACKGROUND
Celiac disease is considered to arise from an inappropriate T-cell-mediated immune response against ingested gluten in genetically predisposed people, whereas the T(H)2-type lymphocytes are mostly involved in IgE-mediated reactions. The matter of possible coexistence of T(H)1- and T(H)2-type diseases is still debated.


OBJECTIVE
This study was aimed to evaluate the allergy prevalence in a large series of adults with untreated celiac disease and their families at the moment of diagnosis. We also evaluated whether 1 year of gluten-free diet had any effect on allergy prevalence in our cohort.


METHODS
At the moment of celiac disease diagnosis a standardized questionnaire was administered for detailed information on presence and type of any allergy symptoms in 1044 adult patients with celiac disease, 2752 relatives, and 318 spouses. Those reporting any allergy underwent tests with dosage of serum levels of total IgE and search for serum specific IgE with a standard makeup of 20 antigens and PRICK tests in selected individuals. At follow-up visit patients with celiac disease were administered the same allergy questionnaire.


RESULTS
One hundred seventy-three patients with celiac disease (16.6%), 523 relative (19%), and 43 spouses (13.5%) had at least 1 allergy (P=not significant). Atopic dermatitis was more frequent in patients with celiac disease (3.8%) and their relatives (2.3%) than in spouses (1.3%). The presence of allergy in general and atopic dermatitis was not affected by presence of overt malabsorption or duration of undiagnosed disease. Follow-up data showed no change in allergy prevalence in the cohort examined.


CONCLUSIONS
Allergy prevalence in a large series of patients with celiac disease is not different from that of their relatives and spouses. However, atopic dermatitis was about 3 times more frequent in patients with celiac disease and 2 times more frequent in their relatives than in spouses. One year of gluten-free diet did not change allergy prevalence in the celiac group under investigation.
Ciacci
Carolina
C
Gastrointestinal Unit, Federico II University of Naples, via Pansini 5, 80131 Naples, Italy. ciacci@unina.it
Cavallaro
Raimondo
R
Iovino
Paola
P
Sabbatini
Francesco
F
Palumbo
Alessandro
A
Amoruso
Daniela
D
Tortora
Raffaella
R
Mazzacca
Gabriele
G
D000328:Adult; D002446:Celiac Disease / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D005983:Glutens / Q000008:administration & dosage; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018454:Spouses; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology
D005983:Glutens