Serological Screening of Celiac Disease in Patients with Juvenile Idiopathic Arthritis

Area of Science:

• Pediatric Rheumatology
• Gastroenterology
• Immunology

Background:

• A potential link exists between celiac disease (CD) and juvenile idiopathic arthritis (JIA).
• Evaluating the serological incidence of CD in JIA patients is important for early detection and management.

Purpose of the Study:

• To determine the serological incidence of celiac disease (CD) in pediatric patients diagnosed with juvenile idiopathic arthritis (JIA).
• To assess the clinical manifestations of CD in this patient cohort.

Main Methods:

• Seventy-eight children under 16 with JIA, inadequately responding to treatment, were enrolled from Tehran University of Medical Sciences (2017-2019).
• CD-related serological screening tests, including Anti-TTG-Ab, were measured.
• Clinical manifestations of CD were evaluated.

Main Results:

• Three patients (3.8%) with oligoarticular JIA showed elevated Anti-TTG-Ab levels, with no reported CD symptoms.
• No significant differences were observed in growth disorders, sex distribution, or JIA subtypes between sero-positive and sero-negative groups.
• Celiac disease was pathologically confirmed in one patient, necessitating a gluten-free diet.

Conclusions:

• The study highlights a 3.8% serological prevalence of celiac disease in children with JIA.
• Absence of gastrointestinal symptoms does not exclude concomitant celiac disease in patients with juvenile idiopathic arthritis.
• Routine serological screening for CD is recommended in JIA patients, irrespective of clinical presentation.