Coeliac disease and Behçet’s disease
- Department of Medicine, St James’s University Hospital, Leeds
- Department of Ophthalmology, St James’s University Hospital, Leeds
- Molecular Medicine Unit, St James’s University Hospital, Leeds
- Department of Medicine, St James’s University Hospital, Leeds
- Department of Medicine, St James’s University Hospital, Leeds
- Department of Ophthalmology, St James’s University Hospital, Leeds
- Molecular Medicine Unit, St James’s University Hospital, Leeds
- Department of Medicine, St James’s University Hospital, Leeds
- Department of Medicine, St James’s University Hospital, Leeds
- Department of Ophthalmology, St James’s University Hospital, Leeds
- Molecular Medicine Unit, St James’s University Hospital, Leeds
- Department of Medicine, St James’s University Hospital, Leeds
- Department of Medicine, St James’s University Hospital, Leeds
- Department of Ophthalmology, St James’s University Hospital, Leeds
- Molecular Medicine Unit, St James’s University Hospital, Leeds
- Department of Medicine, St James’s University Hospital, Leeds
Editor,—A large number of diseases have been reported to be associated with coeliac disease, many with a probable immunological pathogenesis.1 Behçet’s disease and coeliac disease share the feature of recurrent oral ulceration and indeed this may be the only presenting feature of coeliac disease.2 A recent report suggested that there may be an association between these two diseases and that screening for evidence of coeliac disease by antibody screening might be useful in Behçet’s disease to detect otherwise aymptomatic individuals.3 That study tested only 11 individuals but found one with positive antibody tests for coeliac disease, the diagnosis being confirmed by jejunal biopsy.
We have tested the sera of 52 patients attending the supraregional Behçet’s disease clinic at Leeds. All patients fulfilled the diagnostic criteria of the Behçet’s Disease International Study Group.4 We used four coeliac antibody tests (IgG and IgA anti-gliadin antibodies (AGA), IgG anti-reticulin antibodies (ARA), and IgG anti-endomysial antibodies (EMA)). The EMA was negative in all cases, as was the IgA AGA and IgG ARA. Four patients were weakly positive for IgG AGA.
The combination of IgA AGA and IgG EMA has been suggested as the most sensitive and specific combination of serological screening tests for coeliac disease5 and these findings do not support the previously reported association.
Acknowledgments
Work in the authors’ laboratories is supported by the UK Medical Research Council, Northern and Yorkshire Health Authority and The Wellcome Trust.
