Prevalence and predictors of autoimmune gastritis in patients with celiac disease

Celiac disease (CD) is an immune-mediated disease triggered by gluten in genetically susceptible individuals. Autoimmune gastritis (AIG) is an autoimmune disease of the stomach characterized by autoantibodies directed against some structures containing H⁺/K⁺-ATPase and intrinsic factor. Both diseases may lead to micronutrient malabsorption and anemia. The goals of this study were to investigate the prevalence of AIG in patients with CD and determine the possible factors that might predict presence of AIG in patients with CD. Patients diagnosed with CD were investigated and data were collected regarding patient demographics, presence of concomitant autoimmune diseases, serological markers, and micronutrient levels. Diagnosis of CD has been established according to the Marsh classification. AIG was diagnosed according to histopathologic findings. One hundred eighty-three patients with CD were enrolled. Out of 183 patients, there were 19 patients with AIG (10.4%). In multivariable regression analysis, Marsh type 2 CD (odds ratio (OR): 15.838; 95% confidence interval (CI): 4.774-52.545) and the absence of anti-endomysium IgA (OR: 0.257; 95% CI: 0.084-0.786) were identified as predictors of AIG in patients with CD. Ten point four percent of patients with CD also had AIG. Factors that might predict the presence of a concomitant AIG were the presence of Marsh type 2 CD and absence of anti-endomysium IgA in patients with CD. Therefore, we suggest that patients negative for anti-endomysium IgA antibody and who have Marsh type 2 CD should be screened for the presence of AIG.