International Journal of Advances in Medicine | October 2020 | Vol 7 | Issue 10 Page 1475
International Journal of Advances in Medicine
Sunu C et al. Int J Adv Med. 2020 Oct;7(10):1475-1479
http://www.ijmedicine.com
pISSN 2349-3925 | eISSN 2349-3933
Original Research Article
Frequency of celiac disease in patients with vitiligo
Cenk Sunu
1
, Ceyhun Varim
2
*, Cengiz Karacaer
2
, Yasin Kalpakci
1
INTRODUCTION
CD occurs as a result of intolerance to gluten in cereals
such as wheat, barley, oats and rye. The disease
progresses with characteristic histopathological findings
such as inflammation in small intestine and villus
atrophy, and recovery is observed with a gluten-free diet.
1
In most of the CD cases, patients are asymptomatic, or
the disease progresses with minor symptoms, and these
patients are often undiagnosed. Accordingly, true
prevalence of disease in community is unknown.
2-5
The
prevalence of the disease in a screening study conducted
with healthy blood donors in Turkey was found to be
1.3%.
6
In a screening study conducted in European
countries, a high prevalence was observed between 1/80-
1/300 in both healthy children and adults.
7-10
The use of serological tests with high specificity and
sensitivity is beneficial in detecting atypical patients. The
most commonly used serological screening tests are
based on tTG antibodies (IgA and IgG) and anti-
endomysial (EMA) antibodies. The sensitivity and
specificity of tTG antibody assays are above 95%, while
anti-endomysial (EMA) antibody assays have 100%
sensitivity and specificity.
5,11
There are also reports
claiming that the sensitivity of tTG antibodies is
somewhat higher than that of anti-endomysial
antibodies.
12
The definitive diagnosis of CD is made by
duodenal or jejunal biopsy.
1,11
In the classic form of CD, diarrhea, abdominal pain, iron,
folate, calcium, and vitamin D deficiency, and weight
loss are observed. However, it can also be presented by
ABSTRACT
Background: Celiac disease (CD) is an autoimmune and inflammatory disease that occurs in the small intestine as a
result of gluten intake in individuals. Vitiligo, in which autoimmune factors play an essential role, is associated with
depigmentation due to the loss of epidermal melanocytes. Many autoimmune diseases are known to be associated
with vitiligo. This study aims to determine the frequency of CD in vitiligo cases.
Methods: Out of 61 vitiligo patients, 32 (52.4%) are women, and 29 (47.6%) are men; of the 119 healthy volunteers,
58 (48.7%) are women, and 61 (51.3%) are men. Serum levels of tissue transglutaminase (tTG) IgA and tTG IgG
antibodies were measured in all participants. If at least one of these two antibodies are positive, mucosal biopsies
were taken from the second section of the duodenum by endoscopy.
Results: There is no significant difference between the study group and the control group in terms of age and body
mass index (BMI) (p=0.16, p=0.80, respectively). tTG IgA and tTG IgG were positive in one patient in each group. In
both patients, the results of the duodenal biopsy were histopathological compatible with CD. There was no difference
between the vitiligo group and the control group in terms of CD frequency (p=0.56).
Conclusion: The frequency of CD in vitiligo patients is similar to the control group. However, it should be kept in
mind that the frequency of CD in patients with vitiligo may be higher than the rates assumed incidental, and necessary
research should be carried out for early diagnosis in such patients.
Keywords: CD, Vitiligo, Prevalence
1
Department of Hematology,
2
Department of Internal Medicine, Sakarya University Research and Education Hospital,
Sakarya, Turkey
Received: 27 July 2020
Accepted: 02 September 2020
*Correspondence:
Dr. Ceyhun Varim,
E-mail: ceyhunvarim@sakarya.edu.tr
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2349-3933.ijam20204060