Date: Sun, 8 Jul 2001
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.