International Journal of Celiac Disease
ISSN (Print): 2334-3427 ISSN (Online): 2334-3486 Website: http://www.sciepub.com/journal/ijcd Editor-in-chief: Samasca Gabriel
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International Journal of Celiac Disease. 2020, 8(3), 76-82
DOI: 10.12691/ijcd-8-3-1
Open AccessArticle

Sjögren’s Syndrome Associated with Celiac Disease

Felipe Freire Silva1, , Aaron Lerner2, João Carlos Geber Júnior1, Jozélio Freire de Carvalho3 and Yehuda Shoenfeld2, 4

1Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

2Chaim Sheba Medical Center, the Zabludowicz Center, for Autoimmune Diseases Tel-Hashomer, Israel

3Institute for Health Sciences from Federal University of Bahia, Salvador, Bahia, Brazil

4I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Pub. Date: August 02, 2020

Cite this paper:
Felipe Freire Silva, Aaron Lerner, João Carlos Geber Júnior, Jozélio Freire de Carvalho and Yehuda Shoenfeld. Sjögren’s Syndrome Associated with Celiac Disease. International Journal of Celiac Disease. 2020; 8(3):76-82. doi: 10.12691/ijcd-8-3-1

Abstract

Background: Autoimmune diseases tend to run in families and the affected persons are prone to additional autoimmune conditions. This is the case for celiac disease (CD) and Sjögren's syndrome (SS). Objectives: To describe a patient with both diseases and to analyze the clinical, therapeutic and evolutionary characteristics of published patients with SS associated with CD. Methodology: A systematic review of articles published in PubMed, MEDLINE, LILACS and Scielo dating from 1966 to May 2020, was conducted, using the following search words: Sjögren's syndrome, Celiac disease. Only English, German and French publications were considered. Results: Only 16 studies with 31 patients with SS associated CD were depicted. Adding the present case would mount the total to 17 studies, describing 32 patients. There are 6 observational studies and 10 case reports. In relation to demographics, age varied from 10 to 73 years old, with a median of 45 years and the great majority were female (21/32 patients). SS preceded CD manifestations in 7 studies, CD was the first presentation in 6 articles and simultaneous diseases was observed in 4 reports. Time elapsed between the two diseases varied from 2 to 33 years. Autoantibodies related to SS showed that anti-Ro and anti-La were positive in 8/17, while CD-related antibodies were positive in 12/17 studies. Regarding therapy, the majority received a gluten-free diet as CD therapy (13/17 studies). Glucocorticoid was prescribed in 6/17 studies and hydroxychloroquine in 4/17. When described, all studies demonstrated improvement of CD manifestations and 7/17 improved SS symptoms. Conclusion: The present comprehensive review evaluated all published cases of SS and CD of the literature. In the majority, SS precedes CD and all patients had good responses to appropriate therapy. It is hoped that increased awareness of the combination of SS and CD will result in earlier diagnosis and therapy and improved outcome.

Keywords:
Sjögren's syndrome celiac disease dermatitis herpetiformis autoantibodies poly-autoimmunity multiple autoimmune syndrome

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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