Celiac disease more prevalent in children with JIA than general population
Click Here to Manage Email Alerts
Patients with juvenile idiopathic arthritis have a higher prevalence of celiac disease than those without the disease, according to a short report published in Pediatric Rheumatology.
“The lack of data on the risk factors associated with [celiac disease (CD)] and JIA overlap prompted us to investigate the co-occurrence of these two diseases in our JIA pediatric cohort looking for potential predisposing factors,” Roberta Naddei, MD, of the University of Naples Federico II, in Italy, and colleagues wrote. “Understanding the extent of the co-occurrence and identifying factors associated with an increased susceptibility could be relevant to implement case-finding strategies in specific at-risk populations.”
To analyze the prevalence of celiac disease in a population of patients with JIA, Naddei and colleagues conducted a single-center retrospective study by reviewing records of all patients diagnosed with JIA who were admitted to the pediatric rheumatology unit of the University of Naples Federico II between January 2001 and June 2019. All patients included in the analysis were screened for celiac disease, as well as for disease progression every 3 months to 6 months.
The researchers assessed disease activity by way of active joint counts, morning stiffness and inflammatory marker values. Screening for celiac disease was conducted systematically by measuring serum anti-tTG IgA antibodies at the time of JIA diagnoses, as well as annually following the initial diagnosis. When patients were identified as having celiac disease, the researchers collected markers such as age at diagnosis, anti-tTG and anti-endomysium antibody levels, small intestinal pathology reports and human leukocyte antigen typing.
In all, 329 patients with JIA were included in the analysis. According to the researchers, eight of those patients were diagnosed with celiac disease, resulting in a prevalence of 2.4%, compared with 0.93% for the general population of Italy (P < .05). Autoimmunity familiarity was reported in 87.5% of patients with both conditions, compared with 45.8% of patients without celiac disease (P < .05). In all, 87.5% of patients with both conditions required the use of both a biologic and conventional disease-modifying antirheumatic drugs, while 36.4% of patients without celiac disease (P < .05) required the use of both.
“These results underline the importance of CD screening in pediatric JIA patients,” Naddei and colleagues wrote. “This is particularly relevant, since the clinical course of JIA appears to be more aggressive in patients with concomitant CD, who often require a step-up therapy.
“Whether those patients would benefit from an early introduction of a biologic drug needs to be explored,” they added. “Future studies will test whether a first-line genetic testing followed by CD-specific serological screening would be more effective than a first-line serological screening.”
Collapse
Read more about
Click Here to Manage Email Alerts