Autoimmune disorders in patients affected by celiac sprue and inflammatory bowel disease

Background. Although clinically different, celiac sprue and inflammatory bowel disease are characterized by chronic intestinal inflammation and associated extraintestinal manifestations. Aims. To assess and compare the presence of autoimmune disorders in patients affected by celiac sprue and inflammatory bowel disease referred to a single tertiary centre. Methods. From October 2005 to January 2006, a total of 297 consecutive outpatients were enrolled in this cross-sectional study. Diagnoses of celiac sprue and inflammatory bowel disease were based on standard criteria. Data were recorded using an operator-assisted questionnaire: 18 autoimmune diseases, when adequately confirmed, were considered. Results. Clinical characteristics of our patients are in conformity with those of the literature. The prevalence of associated autoimmune diseases was 25.6%, 21.1%, and 10% in patients affected by celiac sprue, Crohn's disease, and ulcerative colitis. Between the prevalence in celiac sprue and Crohn's disease there was no difference, whereas a significant difference was present between these two diseases and ulcerative colitis. The most frequent disorder in all three groups was Hashimoto's thyroiditis. Conclusions. Celiac sprue and Crohn's disease show similar prevalence of associated autoimmune disease, higher than the prevalence in ulcerative colitis. The two diseases share the same pathogenic immunologic response and altered intestinal permeability.