Open Access Highly Accessed Research article

Prevalence of celiac disease in multiple sclerosis

Luis Rodrigo1*, Carlos Hernández-Lahoz2, Dolores Fuentes1, Noemí Alvarez1, Antonio López-Vázquez3 and Segundo González3

Author Affiliations

1 Gastroenterology, Hospital Universitario Central de Asturias (HUCA), c/Celestino Villamil, s. n°., 33006. Oviedo, Spain

2 Neurology, Hospital Universitario Central de Asturias (HUCA), c/Celestino Villamil, s. n°., 33006. Oviedo, Spain

3 Immunology Services Hospital Universitario Central de Asturias (HUCA), c/Celestino Villamil, s. n°., 33006. Oviedo, Spain

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BMC Neurology 2011, 11:31  doi:10.1186/1471-2377-11-31

Published: 7 March 2011

Abstract

Background

Celiac disease (CD) is a common systemic disease related to a permanent intolerance to gluten and is often associated with different autoimmune and neurological diseases. Its mean prevalence in the general population is 1-2% worldwide. Our aim was to study the prevalence of celiac disease in a prospective series of Multiple Sclerosis (MS) patients and their first-degree relatives.

Methods

We analyzed the prevalence of serological, histological and genetic CD markers in a series of 72 MS patients and in their 126 first-degree relatives, compared to 123 healthy controls.

Results

Tissue IgA-anti-transglutaminase-2 antibodies were positive in 7 MS patients (10%), compared to 3 healthy controls (2.4%) (p < 0.05). OR: 5.33 (CI-95%: 1.074-26.425). No differences were found in HLA-DQ2 markers between MS patients (29%) and controls (26%) (NS).

We detected mild or moderate villous atrophy (Marsh III type) in duodenal biopsies, in 8 MS patients (11.1%). We also found a high proportion of CD among first-degree relatives: 23/126 (32%). Several associated diseases were detected, mainly dermatitis 41 (57%) and iron deficiency anemia in 28 (39%) MS patients. We also found in them, an increased frequency of circulating auto-antibodies such as anti-TPO in 19 (26%), ANA in 11 (15%) and AMA in 2 (3%).

Conclusions

We have found an increased prevalence of CD in 8 of the 72 MS patients (11.1%) and also in their first-degree relatives (23/126 [32%]). Therefore, increased efforts aimed at the early detection and dietary treatment of CD, among antibody-positive MS patients, are advisable.