Prevalence of coeliac disease in patients with sarcoidosis.
OBJECTIVE
Susceptibility to sarcoidosis and coeliac disease has been linked to the class II haplotype HLA-DR3, DQ2, and an association between the two disorders has been suggested. As a pilot study, we have sought to determine the prevalence of coeliac disease in a cohort of Irish patients with sarcoidosis.


METHODS
Prospective, case-controlled study.


METHODS
One hundred and two sarcoid patients (47 males, 55 females) from the west of Ireland and 105 (52 males, 53 females) healthy, ethnically matched, controls underwent interview and screening for coeliac disease and human leucocyte antigen typing by serology. Those with elevated anti-gliadin IgA (AGA) and/or positive endomysial antibody (EMA) were offered small intestinal biopsy.


RESULTS
Three (3%) sarcoid patients had a prior diagnosis of coeliac disease. A further 12 (12%) patients and four (4%) controls had elevated AGA (P = 0.047), of whom three and one, respectively, had positive EMA. Small intestinal biopsy in 11 patients and three controls confirmed coeliac disease in one individual each, giving a prevalence of coeliac disease in patients compared with controls of 4/102 (4%) versus 1/105 (1%) (P = 0.21). Sensitivity and specificity of EMA and elevated AGA in sarcoid patients was 100% and 50%, and 50% and 9%, respectively. Of the four affected sarcoid patients, three carried HLA-DR3, DQ2 and one carried DR5 (12), DR7, DQ2.


CONCLUSIONS
We have demonstrated a moderately increased prevalence of coeliac disease in Irish patients with sarcoidosis, which we feel justifies future screening of our sarcoid population. Estimation of EMA is recommended and should be restricted to those with susceptible haplotypes.
Rutherford
Robert M
RM
Department of Respiratory Medicine, Merlin Park Regional Hospital Galway, Ireland. robert.rutherford@northumbria-healthcare.nhs.uk
Brutsche
Martin H
MH
Kearns
Miriam
M
Bourke
Mary
M
Stevens
Fiona
F
Gilmartin
John J
JJ
D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D005903:Gliadin / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D018485:Muscle Fibers, Skeletal / Q000276:immunology; D009130:Muscle, Smooth / Q000276:immunology; D010865:Pilot Projects; D011446:Prospective Studies; D012507:Sarcoidosis / Q000150:complications* / Q000235:genetics
D001323:Autoantibodies; D015415:Biomarkers; D005903:Gliadin