Primary Sjögren's syndrome in patients with celiac disease

Authors: FUNDA ERBASAN, DENİZ TURGUT ÇOBAN, UĞUR KARASU, YEŞİM ÇEKİN, BAYRAM YEŞİL, AYHAN HİLMİ ÇEKİN, DİNÇ SÜREN, MUSTAFA ENDER TERZİOĞLU

Abstract: Background/aim: Many autoimmune diseases occur concomitantly with celiac disease (CD). We aimed to determine the frequency of Sjögren's syndrome (SS) in CD patients based on SS-specific serology verified by minor labial salivary biopsy. Materials and methods: Eight-two patients with CD were included in the study. After examination for objective evidence of sicca complex, all patients were tested for serological presence of rheumatoid factor (RF) and antinuclear antibodies (ANAs) and for ANA profile. Minor labial salivary biopsy was performed for patients with positive serology and/or clinical signs of SS. Results: Of the patients included, 24 (29.3%) had dry eye symptoms while 20 (24.4%) had dry mouth symptoms. Dry eye was detected by Schirmer test in 10 patients (12.2%) and by ocular staining score in only 2 patients (2.4%). All samples were negative for RF while 12 (14.6%) samples were positive for ANAs. Of 82 patients with CD, the diagnosis of SS was established in only one patient (1.2%), while one patient (1.2%) was diagnosed with morphea and 4 patients (4.9%) were classified as having undifferentiated connective tissue disease. Conclusion: The prevalence of SS in CD is low, so there is no need for serologic screening of all patients with CD for SS.

Keywords: Celiac disease, Sjögren's syndrome, antinuclear antibodies, connective tissue disorders

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