title: Prevalence and clinical relevance of enteropathy associated with systemic autoimmune diseases.
abstract: OBJECTIVE
  To assess whether systemic autoimmune diseases are a risk group for coeliac disease and if there is a systemic autoimmune diseases-associated enteropathy.
  
  
  METHODS
  183 patients with systemic autoimmune diseases were included. Duodenal biopsy was carried out on patients with positive coeliac genetics (HLA-DQ2-DQ8) and/or serology and/or symptoms of the coeliac disease spectrum. When enteropathy was found, causes, including gluten sensitivity, were investigated and categorized according to a sequentially applied treatment. Results were analysed with Chi-square or Fisher exact tests.
  
  
  RESULTS
  The prevalence of coeliac disease with atrophy was 0.55% (1 of 183 patients). Thirty-eight of the 109 patients (34.8%) who underwent duodenal biopsy had lymphocytic enteropathy (8 infectious, 5 due to gluten sensitive enteropathy, 5 HLA-DQ2/DQ8 who did not accept gluten-free diet and 20 of unknown aetiology). Lymphocytic enteropathy was unrelated to disease activity or immunosuppressants. HLA-DQ2 was more frequent in connective tissue disease (41.5%) compared with systemic vasculitis and autoinflammatory diseases (17.9%) (p=0.02), whereas a lower percentage of lymphocytic enteropathy was observed in the former (20.2% vs. 41.6%). Lymphocytic enteropathy was clinically irrelevant in cases with no definite aetiology.
  
  
  CONCLUSIONS
  One third of systemic autoimmune diseases patients had enteropathy of uncertain clinical meaning in the majority of cases, which was rarely due to gluten sensitive enteropathy.
authors.affiliation: Department of Internal Medicine, Hospital Universitari MútuaTerrassa, Fundació per la Recerca MútuaTerrassa, Universitat de Barcelona, Plaza Dr. Robert 5, Terrassa, Catalonia, Spain.
authors.forename: Maria-José
authors.initials: MJ
authors.lastname: Vives
authors.forename: Maria
authors.initials: M
authors.lastname: Esteve
authors.forename: Meritxell
authors.initials: M
authors.lastname: Mariné
authors.forename: Fernando
authors.initials: F
authors.lastname: Fernández-Bañares
authors.forename: Montserrat
authors.initials: M
authors.lastname: Alsina
authors.forename: Antonio
authors.initials: A
authors.lastname: Salas
authors.forename: Carme
authors.initials: C
authors.lastname: Loras
authors.forename: Anna
authors.initials: A
authors.lastname: Carrasco
authors.forename: Pere
authors.initials: P
authors.lastname: Almagro
authors.forename: Josep M
authors.initials: JM
authors.lastname: Viver
authors.forename: Mónica
authors.initials: M
authors.lastname: Rodriguez-Carballeira
mesh_terms: D000328:Adult; D001284:Atrophy / Q000150:complications; D001327:Autoimmune Diseases / Q000097:blood / Q000150:complications* / Q000235:genetics; D002446:Celiac Disease / Q000097:blood / Q000150:complications* / Q000235:genetics / Q000473:pathology*; D016009:Chi-Square Distribution; D003240:Connective Tissue Diseases / Q000276:immunology; D055050:Diet, Gluten-Free; D004386:Duodenum / Q000473:pathology*; D005260:Female; D005838:Genotype; D006683:HLA-DQ Antigens / Q000097:blood / Q000235:genetics*; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006801:Humans; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D056647:Systemic Vasculitis / Q000276:immunology
chemical_list: D006683:HLA-DQ Antigens; C109756:HLA-DQ8 antigen