Selective increase of IgA rheumatoid factor in patients with gluten sensitivity

An increased prevalence of raised autoantibodies, including rheumatoid factor, has been reported in patients with gluten sensitivity. However, rheumatoid factor has only been measured in small groups of patients and the findings have been conflicting. In this study IgM, IgG and IgA rheumatoid factor was measured in 89 patients with dermatitis herpetiformis and 22 patients with coeliac disease and compared with 89 normal controls. There was an increased prevalence of elevated IgA rheumatoid factor in the patients with dermatitis herpetiformis (13.5%; p = 0.036) and coeliac disease (18.2%; p = 0.078), while no such increase was found for the IgM or IgG rheumatoid factor isotypes. This selective increase of IgA rheumatoid factor suggests that rheumatoid factor production in patients with gluten sensitivity primarily results from immunological activation in the gut mucosa.