title: Screening for celiac disease, by endomysial antibodies, in patients with unexplained articular manifestations.
abstract: Celiac disease (CD) is an autoimmune systemic disease characterized by not only gastrointestinal but also extraintestinal manifestations. The aim of our study was to do a serological screening for CD, by IgA endomysial antibodies (EmA), in patients with unexplained articular manifestations. Two hundred and eleven patients suffering from arthritis or arthralgia without evident cause were studied. EmA were determined by indirect immunofluorescence on human umbilical cord. Two thousand and five hundred blood donors served as control group. Out of 211 patients, 5 had EmA (2.37 %). The frequency of EmA in our patients was significantly higher than in the control group (2.37 vs. 0.28 %, p < 0.01). All patients with positive EmA were female. EmA were significantly more frequent in female patients than in female healthy subjects (3 vs. 0.4 %, p < 0.01). Medical records revealed: diarrhea (one patient), short size (one patient), anemia (three patients), weight loss (two patients) spontaneous abortion (three patients), secondary amenorrhea (one patient), early menopause (one patient) and early baby death (one patient). Biochemical analysis showed decreased level of calcium (one patient), vitamin D (one patient) and cholesterol (one patient). Unexplained liver cytolysis was observed in two patients. Radiological examination showed demineralization of two hands in one patient. Bone osteodensitometry done in one patient out of five revealed lumbar osteopenia. The articular manifestations of the five patients did not respond to corticosteroid treatment. CD must be considered among the differential diagnosis in a patient with arthritis or arthralgia.
authors.affiliation: Department of Immunology, Farhat Hached University Hospital, Sousse, Tunisia.
authors.forename: Mariam
authors.initials: M
authors.lastname: Ghozzi
authors.forename: Wahiba
authors.initials: W
authors.lastname: Sakly
authors.forename: Amani
authors.initials: A
authors.lastname: Mankaï
authors.forename: Elyes
authors.initials: E
authors.lastname: Bouajina
authors.forename: Fethi
authors.initials: F
authors.lastname: Bahri
authors.forename: Rafiaa
authors.initials: R
authors.lastname: Nouira
authors.forename: Chedia
authors.initials: C
authors.lastname: Kechrid
authors.forename: Ibtissem
authors.initials: I
authors.lastname: Ghedira
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000175:diagnosis / Q000209:etiology*; D001168:Arthritis / Q000175:diagnosis / Q000209:etiology*; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002446:Celiac Disease / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D003937:Diagnosis, Differential; D005260:Female; D019204:GTP-Binding Proteins; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012189:Retrospective Studies; D012307:Risk Factors; D012698:Serologic Tests; D012737:Sex Factors; D011503:Transglutaminases / Q000276:immunology*; D014416:Tunisia; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D007070:Immunoglobulin A; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins