Date:    Sun, 8 Jul 2001 22:07:53 -0600
Sender:  Celiac/Coeliac Wheat/Gluten-Free List 
From:    Ron Hoggan 
Subject: Re: Subject: lupus - any connection?

> There is a man in my church with Lupus and he is very close to death. He
> has 5 children under 12 years. I have been looking through Lupus
> information to see if there is any connection between CD and Lupus.
> Nothing points in this direction, but I seem to remember a discussion on
> the list a while back for a possible connection between Lupus and CD. I
> just don't remember the outcome of this discussion. Has a connection
> been found? Does anyone know anything and could give me some pointers?

Hi Butze,
I am posting to the list on this thread because I suspect that it may be of
interest to others. In response to your post I ran a Medline search of
celiac disease and lupus. I got 43 citations. Because it was on Medline, I
was restricted to reading abstracts, and only some were available.
Publication in other languages, letters, etc. left only a few abstracts to
work from, but they tell an interesting tale: 

The first of the 8 abstracts I read found that 23% of 104 lupus patients
had anti-gliadin antibodies. They called these false positives because no
endomysium antibodies were found, and no villous atrophy was identified
(1). I have a different view. I consider these folks to be gluten
sensitive, and suspect that they would benefit hugely from a strict
gluten-free diet. DH is another gluten-induced disease that sometimes does
not show convincing evidence of villous atrophy, yet it is clearly
benefitted  by avoidance of gluten.

The second abstract identifies malabsorption in 9.5% of their lupus
subjects, and an even higher percentage showed evidence of fat
malabsorption (2).

The next 5 abstracts all report cases where both lupus and celiac were
found in the same patients (3,4,5,6,7). The subsequent three have titles
that suggest a connection, so I included them in this post as well.

Sources:

1:  Rensch MJ, Szyjkowski R, Shaffer RT, Fink S, Kopecky C, Grissmer L,
Enzenhauer R, Kadakia S.  The prevalence of celiac disease autoantibodies in
patients with systemic lupus erythematosus. Am J Gastroenterol. 2001
Apr;96(4):1113-5.

2:  Mader R, Adawi M, Schonfeld S. Malabsorption in systemic lupus
erythematosus. Clin Exp Rheumatol. 1997 Nov-Dec;15(6):659-61.

3:  Cote HC, Huntsman DG, Wu J, Wadsworth LD, MacGillivray RT. A new method
for characterization and epitope determination of a lupus
anticoagulant-associated neutralizing antiprothrombin antibody. Am J Clin
Pathol. 1997 Feb;107(2):197-205.

4:  Komatireddy GR, Marshall JB, Aqel R, Spollen LE, Sharp GC. Association
of systemic lupus erythematosus and gluten enteropathy. South Med J. 1995
Jun;88(6):673-6.

5:  Mukamel M, Rosenbach Y, Zahavi I, Mimouni M, Dinari G. Celiac disease
associated with systemic lupus erythematosus. Isr J Med Sci. 1994
Aug;30(8):656-8.

6:  Varkel Y, Braester A, Suprun H, Nusem D, Horn Y. Simultaneous occurrence
of systemic lupus erythematosus and coeliac disease-like features. Postgrad
Med J. 1989 Aug;65(766):600-2.

7:  Rustgi AK, Peppercorn MA. Gluten-sensitive enteropathy and systemic
lupus erythematosus. Arch Intern Med. 1988 Jul;148(7):1583-4.

8:  Roberts DL. Sub-acute cutaneous lupus erythematosus and gluten sensitive
enteropathy. Br J Dermatol. 1988 May;118(5):731-2.

9:  Pena AS. Systemic lupus erythematosus, Sjogren's syndrome, and purpura
in a patient with coeliac disease. Neth J Med. 1987 Dec;31(5-6):305-7.

10:  Bazinet P, Marin GA. Malabsorption in systemic lupus erythematosus. Am
J Dig Dis. 1971 May;16(5):460-6.

I hope that my comments prove helpful.
best wishes,
Ron Hoggan