LA COMPLICANZA ARTICOLARE DELLA MALATTIA CELIACA. STUDIO SU 62 CASI: RISULTATI PRELIMINARI

In a co-operative study, 62 adult coeliac patients (17 M, 45 F) (mean age 33.8, range 17-76 yrs) (mean duration of the intestinal disease 78 months), consecutively attending routine gastroenterology follow-up, were questioned and examined for evidence of articular involvement. All patients had been under gluten-free dietary regimen for almost 58 months, with complete remission of intestinal symptoms, confirmed by jejunal biopsy. Rheumatological examination included: 1) a questionnaire on the onset, duration and characteristics of rheumatic symptoms; 2) clinical and radiological detection of peripheral and/or axial involvement, with the assessment of its activity. CRP, ESR, Latex test and Waaler Rose were performed on all patients. Eleven out of 62 (18%) showed an articular involvement. In 8 cases it was localized to peripheral joints, while in 3 it concerned axial skeleton. No erosions were found on x ray films and all patients were seronegative for rheumatoid factor. Coeliac disease is a condition associated with abnormal intestinal permeability, in which an unidentified provoking antigen may play a role in development of related extraintestinal features, such articular. Arthritis is thought to be a rare complication in subjects treated with appropriate dietary regimen. Our results contrast with this idea and outline the need for careful rheumatological follow-up in these patients.