title: The enthesopathy of celiac patients: effects of gluten-free diet.
abstract: Celiac disease (CD) is a gluten-sensitive enthesopathy occurring in genetically predisposed individuals that is caused by a permanent intolerance to gluten. The major environmental factor associated with the risk of developing celiac-related complications is persistent exposure to dietary gluten. The aim of this study was to determine the prevalence of lower limb enthesopathy in CD patients at first diagnosis compared with CD patients on a gluten-free diet (GFD). Fifty-five untreated CD patients (group A) and 55 CD patients on a GFD from at least 1 year (group B), matched for age and sex, attending gastroenterology outpatient clinic of the University Federico II of Naples, were enrolled in this study. All patients underwent clinical and ultrasonography examination. Among group A, 27 (49.8 %) patients presented at least one entheseal alteration as compared with 15 patients (27.2 %) of group B (prevalence rate ratio 1.83, I.C. 95 % = 0.48-7.01; p < 0.001). The Glasgow ultrasound enthesitis scoring system (GUESS) was significantly higher in patients of group A than in patients of group B. In conclusion, our study shows that enthesopathy is more frequent in untreated CD subjects with positive anti-tissue transglutaminase antibodies title, as compared to those on GFD and absence of serum anti-tissue transglutaminase antibodies title.
authors.affiliation: Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II, via S. Pansini 5, Naples, 80131, Italy, m.atteno@alice.it.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Atteno
authors.forename: Luisa
authors.initials: L
authors.lastname: Costa
authors.forename: Antonio
authors.initials: A
authors.lastname: Cozzolino
authors.forename: Raffaella
authors.initials: R
authors.lastname: Tortora
authors.forename: Francesco
authors.initials: F
authors.lastname: Caso
authors.forename: Antonio
authors.initials: A
authors.lastname: Del Puente
authors.forename: Luca
authors.initials: L
authors.lastname: Cantarini
authors.forename: Raffaele
authors.initials: R
authors.lastname: Scarpa
authors.forename: Carolina
authors.initials: C
authors.lastname: Ciacci
mesh_terms: D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000276:immunology; D002446:Celiac Disease / Q000150:complications / Q000178:diet therapy* / Q000276:immunology; D015331:Cohort Studies; D055050:Diet, Gluten-Free; D005260:Female; D033023:Foot Joints / Q000000981:diagnostic imaging*; D019204:GTP-Binding Proteins / Q000276:immunology; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012216:Rheumatic Diseases / Q000000981:diagnostic imaging / Q000178:diet therapy* / Q000209:etiology; D011503:Transglutaminases / Q000276:immunology; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins