Anti-transglutaminase, antigladin and ultra purified anti-gladin antibodies in patients with a diagnosis of rheumatoid arthritis

Dionisio Castillo-Ortiz, José; Durán-Barragán, Sergio; Sánchez-Ortíz, Adriana; Ramos-Remus, Cesar

doi:10.1016/S2173-5743(11)70005-3

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Abstract

Celiac disease (CD) is an enteric disease caused by dietary gluten in individuals with genetic predisposition. One of the clinical manifestations of CD is peripheral arthritis that may simulate RA.

Objective

To determine the frequency of anti-gliadin (aGL), anti-tissue transglutaminase (aTGT) and ultra purified anti-gliadin (AGLU) antibodies in patients with RA.

Methods

Cross-sectional study. We included consecutive patients diagnosed as RA (ACR). Demographic and clinical data were registered by direct interview and serum levels of aGL, aTGT and aGLU were determined using ELISA.

Results

Eighty-five RA patients were included; 87% were women. Mean age was 44±12 years, mean disease duration 12±9 years. IgG aGL antibodies were positive in 16 patients, IgA aGL antibodies in 29 patients, Aglu in 14 patients and only one patient had aTGT.

Conclusions

It is possible that CD may be the correct diagnosis in a patient with polyarthritis, even if the patient meets the ACR criteria for RA. In other words, CD should be considered among the differential diagnoses in a patient with polyarthritis.

Keywords:

Rheumatoid arthritis

Celiac disease

Anti-tissue transglutaminase

Anti-gliadin and ultra purified anti-gliadin antibodies

Resumen

La enfermedad celiaca (EC) es una afección entérica ocasionada por la ingesta de granos que contienen gluten. Una manifestación clínica poco reconocida es la artritis periférica, que puede simular artritis reumatoide.

Objetivo

Determinar la frecuencia de anti-Gliadina (aGL), anti Transglutaminasa Tisular (aTGT) y anti-Gliadina Ultra-purificada (aGLU) en pacientes con diagnóstico de AR.

Métodos

Es un estudio transversal de pacientes con AR (criterios ACR). Se registraron variables demográficas y clínicas y se les realizaron determinaciones séricas de anticuerpos aGL, aGLU y aTGT por ELISA.

Resultados

Se incluyeron 85 pacientes con AR. El 87% de los pacientes fueron mujeres. El promedio de edad fue de 44 años ± 12, con una media de 12±9 años de evolución. Los anticuerpos aGL IgG estuvieron positivos en 16 pacientes, los aGL IgA en 29 pacientes, la aGLU en 14 pacientes y solo un paciente fue positivo para aTGT.

Conclusiones

Es posible que pacientes con poliartritis y que cumplan con los criterios de clasificación de AR puedan tener de hecho EC. De otra forma, la EC debe considerarse dentro del diagnóstico diferencial de poliartritis.

Palabras clave:

Artritis reumatoide

Enfermedad celiaca

Anticuerpos anti-transglutaminasa tisular

Anti-gliadina y anti-Gliadina ultra-purificada

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