JUVENILE CHRONIC ARTHRITIS AND CELIAC-DISEASE IN THE NETHERLANDS

Objective. It has been suggested that juvenile chronic arthritis (JCA) is associated with coeliac disease in a frequency of 0.4-2%. In order to investigate the frequency of coeliac disease in cases of JCA and t he possibility of underdiagnosis in our area, we screened 62 children with JCA (mean age 9.8 +/- 3.5 year) for coeliac disease. Methods. All children were screened for coeliac disease by measuring the IgA-class of antigliadin, antireticulin and antiendomysium antibodies in serum and by measuring intestinal permeability by a sugar absorption test us ing lactulose and mannitol. In cases of at least one positive test, a small-bowel biopsy for diagnosis of coeliac disease was offered. Resul ts. Of the 62 children with JCA, 8 had an abnormal screening result an d were suspected of having coeliac disease. In four of the five childr en in whom a small-bowel biopsy was performed, the intestinal mucosa w as normal and in one child villous atrophy characteristic of coeliac d isease was found. Therefore, the prevalence of coeliac disease in our study group was 1.5%, which is in agreement with the literature. Concl usion. These findings indicate no underdiagnosis of coeliac disease in JCA in our area.