title: Fibromyalgia and coeliac disease: a media hype or an emerging clinical problem?
abstract: OBJECTIVE
  Fibromyalgia (FM) association with autoimmune diseases has been widely reported in literature. Coeliac disease (CD) is a small intestine immune-mediated disorder triggered by gluten ingestion in genetically predisposed patients. In recent years, the Internet and the non-medical press have reported a correlation between gluten-related disorders and fibromyalgia-like symptoms. The aim of our study was to verify a possible association between FM and CD, by assessing the prevalence of CD in a cohort of FM patients and vice versa.
  
  
  METHODS
  90 consecutive subjects from our Rheumatologic outpatient clinic who had been diagnosed with FM were serologically tested for CD and positive patients underwent esophagogastroduodenoscopy to obtain duodenal biopsies. A second group of 114 consecutive subjects from our Coeliac Disease outpatient clinic were investigated for the presence of FM-like symptoms through a questionnaire. Patients reporting chronic widespread pain were addressed to a rheumatologist for further evaluation.
  
  
  RESULTS
  The overall prevalence of CD in our FM patients was identical to that expected in general population (around 1%). In our CD group 17 patients (14.9%) reported chronic widespread pain at the questionnaire and 13 (11.4%) satisfied ACR 1990 criteria for FM. Their symptoms had not been modified by GFD.
  
  
  CONCLUSIONS
  A serological screening for CD is not recommended in FM patients but rather a case-finding strategy should be performed. At the same time, proposals of GFD in FM patients, in absence of a well-established diagnosis of CD, should be rigorously avoided.
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. francesco.tovoli@studio.unibo.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Tovoli
authors.forename: Luca
authors.initials: L
authors.lastname: Giampaolo
authors.forename: Giacomo
authors.initials: G
authors.lastname: Caio
authors.forename: Marco
authors.initials: M
authors.lastname: Monti
authors.forename: Maria
authors.initials: M
authors.lastname: Piscaglia
authors.forename: Magda
authors.initials: M
authors.lastname: Frisoni
authors.forename: Luigi
authors.initials: L
authors.lastname: Bolondi
authors.forename: Umberto
authors.initials: U
authors.lastname: Volta
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis / Q000453:epidemiology*; D059350:Chronic Pain / Q000175:diagnosis / Q000453:epidemiology*; D016145:Endoscopy, Digestive System; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011237:Predictive Value of Tests; D015995:Prevalence; D011795:Surveys and Questionnaires; D055815:Young Adult