The frequency of Celiac disease in primary Sjögren’s syndrome

Objective: Primary Sjögren’s syndrome (pSS) is a systemic autoimmune disease characterized by lymphocytic infiltration of the exocrine glands, affecting many organs. Celiac disease (CD), which causes inflammatory damage to the small intestine, develops as a result of the immunological response to gluten. The incidence of CD has increased in pSS. This research aims to investigate the frequency of CD in pSS. Methods: This is a cross-sectional study conducted in a single-center between 2019 and 2020. A total of 90 patients diagnosed with pSS were questioned regarding CD symptoms. Laboratory tests and small bowel biopsies were requested from patients with suspected CD. Anti-gliadin immunoglobulin (Ig)A and IgG, anti-tissue transglutaminase (anti-TTG) IgA and IgG antibodies from celiac antibodies were evaluated using the ELISA method, and anti-endomysium IgA and IgG were evaluated by indirect immunofluorescence. Upper gastrointestinal endoscopy was performed in patients with CD symptoms and autoantibody positivity. The diagnosis of CD was made according to endoscopic biopsy results. Results: The pSS patients comprised 98% females, with a mean age of 51.6±11.5 years. The rates of CD symptoms were as follows: 10% loss of appetite, 13.3% abdominal pain, 11.1% diarrhea, 18.9% constipation, 37.8% flatulence, and 2.2% weight loss. Anti-gliadin IgA positivity was determined in 6.7%, anti-gliadin IgG in 6.7%, anti-endomysium IgA in 2.2%, anti-endomysium IgG in 15.6%, and IgA in 1.1%. Gastroscopy was planned for 43 patients with suspected CD based on clinical and laboratory findings. CD was diagnosed in two patients before this study; subsequently, four more patients were diagnosed with CD. Conclusion: The findings of this investigation revealed a 6.7% prevalence of CD in pSS. The diagnosis of CD in pSS was supported by histopathology. According to these findings, CD is more prevalent in pSS patients, and the risk of developing CD is higher than that in the general population.