Coeliac disease in spondyloarthropathy: usefulness of serological screening

The aim of our study was to find unidentified or neglected cases of coeliac disease by using serological screening in a group of patients with spondyloarthropathies. Altogether, 74 consecutively hospitalised patients (28 females, 46 males, from 15 to 72 years of age, mean age 40.4+/-1.6 years) with spondyloarthropathies were investigated by serological screening tests for coeliac disease. IgA- and IgG-type antigliadin antibodies were determined using an enzyme-linked immunosorbent assay, and IgA- and IgG-type antireticulin and IgA-type antiendomysium antibodies were measured by an indirect immunofluorescence method. An increased level of antigliadin antibodies was found in nine (12%) of the studied patients and in one of them, antiendomysium antibodies were revealed. In this HLA B8-positive patient, typical villous atrophy with crypt hyperplasia was found in the small bowel biopsy specimen, which confirmed the diagnosis of coeliac disease. None of the patients had IgA- and IgG-type antireticulin antibodies. We found an association of spondyloarthropathy with coeliac disease in one patient out of 74. Clinicians need to be aware of this association, which has important implications for the correct management of patients.