CD & sarcoidosis.

[kickingfrog]

Eur J Gastroenterol Hepatol. 2004 Sep;16(9):911-5.

Prevalence of coeliac disease in patients with sarcoidosis.

Rutherford RM, Brutsche MH, Kearns M, Bourke M, Stevens F, Gilmartin JJ.

Source
Department of Respiratory Medicine, Merlin Park Regional Hospital Galway, Ireland. [e-mail]

Abstract
OBJECTIVE: Susceptibility to sarcoidosis and coeliac disease has been linked to the class II haplotype HLA-DR3, DQ2, and an association between the two disorders has been suggested. As a pilot study, we have sought to determine the prevalence of coeliac disease in a cohort of Irish patients with sarcoidosis.

DESIGN: Prospective, case-controlled study.

METHODS: One hundred and two sarcoid patients (47 males, 55 females) from the west of Ireland and 105 (52 males, 53 females) healthy, ethnically matched, controls underwent interview and screening for coeliac disease and human leucocyte antigen typing by serology. Those with elevated anti-gliadin IgA (AGA) and/or positive endomysial antibody (EMA) were offered small intestinal biopsy.

RESULTS: Three (3%) sarcoid patients had a prior diagnosis of coeliac disease. A further 12 (12%) patients and four (4%) controls had elevated AGA (P = 0.047), of whom three and one, respectively, had positive EMA. Small intestinal biopsy in 11 patients and three controls confirmed coeliac disease in one individual each, giving a prevalence of coeliac disease in patients compared with controls of 4/102 (4%) versus 1/105 (1%) (P = 0.21). Sensitivity and specificity of EMA and elevated AGA in sarcoid patients was 100% and 50%, and 50% and 9%, respectively. Of the four affected sarcoid patients, three carried HLA-DR3, DQ2 and one carried DR5 (12), DR7, DQ2.

CONCLUSION: We have demonstrated a moderately increased prevalence of coeliac disease in Irish patients with sarcoidosis, which we feel justifies future screening of our sarcoid population. Estimation of EMA is recommended and should be restricted to those with susceptible haplotypes.

PMID:15316417[PubMed - indexed for MEDLINE]

[kickingfrog]

Sarcoidosis and coeliac disease.

by .Jonas F Ludvigsson, Jan Wahlstrom, Johan Grunewald, Anders Ekbom, Scott M Montgomery

Lancet (1984)

Volume: 2, Issue: 8403, Pages: 408

Abstract
BACKGROUND AND AIM: Several case reports indicate a link between coeliac disease (CD) and sarcoidosis. Our main objective was to investigate the risk of subsequent sarcoidosis in individuals with CD in a general population cohort study. A second aim was to estimate the risk of CD in individuals with prior sarcoidosis.
METHODS: We used Cox proportional hazards method to calculate the risk of subsequent sarcoidosis in 14,349 individuals who had received a diagnosis of CD (1964-2003) and 69,998 age- and sex-matched individuals without a diagnosis of CD. Subjects were identified through the Swedish national Inpatient Register. Conditional logistic regression was used to study the risk of CD associated with prior sarcoidosis.
RESULTS: CD was associated with an increased risk of sarcoidosis (Hazard ratio (HR) = 4.03; 95% CI = 2.32-7.00; p < 0.001), and was not notably affected by adjustment for socioeconomic index. In individuals with CD listed as the main diagnosis, the HR was 3.66 (95% CI HR = 1.80-7.45; p < 0.001). Prior sarcoidosis was associated with an increased risk of CD (Odds ratio = 3.58; 95% CI = 1.98-6.45; p < 0.001).
CONCLUSION: Immune characteristics of CD may be linked to an increased risk of sarcoidosis.

[kickingfrog]

Scarcoidosis and Coeliac

Posted by Charlotte, Oxford on 22/3/2012

GF Board

These are the refs I have on the 2 conditions - (not edited or updated for a couple of years so may not all be relevant). There is a connection. All the evidence suggests that coeliacs who start the treatment in childhood are less prone to other autoimmune disorders in adulthood.

Sarcoidosis & Coeliac Disease

www.coeliac.co.uk/other/TextOnly/?ContentID=177&FontSize=0
There has been shown to be a moderately increased prevalence of coeliac disease in patients with sarcoidosis of approximately 4%

www.celiac.com/articles/126/1/Sarcoidosis-and-Celiac-Disease/Page1.html
Sarcoidosis and Celiac Disease Scott Adams. Ron Hoggan with refs

cat.inist.fr/?aModele=afficheN&cpsidt=16027746
Prevalence of coeliac disease in patients with sarcoidosis. Eur J Gastroenterol Hepatol. 2004
Rutherford et al Merlin Park Regional Hospital Galway, Ireland

www.stopsarcoidosis.org/news/researchnews.htm
www.stopsarcoidosis.org/news/researchnewsarchive.htm
Genetic research has suggested an association between sarcoidosis and celiac disease. Celiac disease is an inherited, autoimmune disease in which the lining of the small intestine is damaged in response to ingestion of gluten and other proteins found in wheat, barley, rye, possibly oats and their derivatives. Blood tests and biopsy in this pilot study of 102 sarcoidosis patients (47 males, 55 females) and 105 (52 males, 53 females) healthy, ethnically matched, controls demonstrated a moderately increased prevalence of celiac disease in Irish patients with sarcoidosis.

www.springerlink.com/content/n674k365q8833802/
Sarcoidosis and coeliac disease: an association? Douglas et al.
An association between sarcoidosis and coeliac disease is suggested by the occurrence of both diseases in 5 patients. In 3 cases the gastrointestinal symptoms of coeliac disease preceded those of sarcoidosis and in the other 2 patients symptoms of both diseases appeared at the same time.

de.scientificcommons.org/7601715
Title: Polyglandular Autoimmune (PGA) Syndromes and associations to sarcoidosis
Editor: Papadopoulos, Konstantinos I. Year: 1999
The high frequency of associated autoimmunity in sarcoidosis supports a role for this disease in the manifestation of autoimmunity. Our findings support the hypothesis that different immunogenetic profiles exist in sarcoidosis indicative of distinct clinical subgroups

Evidence of gastrointestinal immune reactivity in patients with sarcoidosis.
Papadopoulos et al B. J Intern Med. 1999 Malmo University Hospital, Sweden.
CONCLUSION: We have demonstrated a high frequency of gastric autoimmunity and gluten-associated immune reactivity in patients with sarcoidosis, occurring in almost 40% of the cases, the former being the most frequent gastrointestinal immune manifestation. Despite a high frequency of humoral autoimmunity, the frequencies of clinical disease, pernicious anaemia and coeliac disease were not increased as compared with the control population.

gut.bmjjournals.com/cgi/content/abstract/29/12/1628
Altered gastrointestinal immune response in sarcoidosis Gut, Vol 29, 1628-1631, Copyright © 1988 by BMJ Publishing Group
…These findings suggest that in patients with sarcoidosis, there is an altered gastrointestinal mucosal immune response, accompanied in about 40% of patients by specific sensitisation to wheat protein.

groups.google.com/group/bit.listserv.celiac/browse_thread/thread/4032eee78e3c2ef6/d9398ac921503de6

www.ncbi.nlm.nih.gov/pubmed/17934825
Sarcoidosis in Patients with Celiac Disease
Elizabeth Hwang et al, NY Journal Digestive Diseases and Sciences 2008
Conclusions In this cohort of patients with celiac disease, there was a significantly increased risk of sarcoidosis when compared with the American white population. This further strengthens prior associations that have been made suggesting a shared mechanism behind the etiologies of celiac disease and sarcoidosis.

Am J Respir Crit Care Med. 2001 Dec 1;164(11):2085-91. Links
Familial aggregation of sarcoidosis. A case-control etiologic study of sarcoidosis (ACCESS). Rybicki et al
In summary, a significant elevated risk of sarcoidosis was observed among first- and second-degree relatives of sarcoidosis cases compared with relatives of matched control subjects.

Other general:

www.sarcinfo.com/phorum/read.php?f=1&i=26305&t=26305
www.sila.org.uk/
www.bbc.co.uk/health/conditions/sarcoidosis1.shtml
British Lung Foundation Tel: [phone] Website: www.britishlungfoundation.com

US:
www.webmd.com/a-to-z-guides/sarcoidosis-11087
American Autoimmune Related Diseases Association, Inc. www.aarda.org/
Sarcoidosis Research Institute www.sarcoidosisresearch.org
American Lung Association www.lungusa.org

Acute sarcoidosis:

www.lycos.com/info/sarcoidosis--acute-sarcoidosis.html
www.aafp.org/afp/20040715/312.html

Lofgren's syndrome:

www.patient.co.uk/showdoc/40025289/
www.aafp.org/afp/20000215/tips/14.html