The prevalence of celiac disease autoantibodies in patients with systemic lupus erythematosus

OBJECTIVE: Systemic lupus erythematosus has been associated with false posi tive autoantibodies for primary biliary cirrhosis. chronic active hepatitis , Sjogren's syndrome, rheumatoid arthritis, thyroid disorders, syphilis, an d scleroderma. An increased prevalence of autoantibodies are found in celia c disease and systemic lupus erythematosus, which share the human lymphocyt e HLA-B8 and HLA-DR3 histocompatibility antigens. This study examines the p revalence of celiac disease autoantibodies in systemic lupus erythematosus patients. METHODS: Patients observed in the Department of Rheumatology at our institu tions in San Antonio, Texas with known systemic lupus erythematosus were of fered participation in the study. One hundred three of the 130 patients con tacted agreed to participate. Patients were excluded if they were pregnant or medically unable to undergo endoscopy. All volunteers were tested for th e serological presence of IgA and IgM antigliadin and IgA antiendomysial an tibodies. Those with positive serology underwent esophagogastroduodenoscopy with duodenal mucosal biopsy. RESULTS: Twenty-four of 103 (23.3%) systemic lupus erythematosus patients t ested positive for either antigliadin antibody, whereas none of the 103 pat ients tested positive for antiendomysial antibody. None of the 24 antigliad in positive patients were found to have endoscopic or histological evidence of celiac disease, making the false positive rate of antigliadin antibody 23%. CONCLUSION: The presence of false positive antigliadin antibodies in patien ts with systemic lupus erythematosus is common. Despite shared human lympho cyte antigen loci there does not seem to be an association between celiac d isease and systemic lupus erythematosus. (Am J Gastroenterol 2001;96.1113-1 115. (C) 2001 by Am. Coll. of Gastroenterology).