The prevalence of coeliac disease antibodies in patients with the antiphospholipid syndrome

Abstract

High prevalence of coeliac disease (CD) has been reported in various autoimmune disorders, but has not been studied in the antiphospholipidsyndrome (APS). We aimed to establishthe prevalenceof CD antibodiesin a cohort of APS patients, and to examine whether CD may be responsiblefor some of the manifestationsof APS. Fifty-seven patients (47 females, 10 males) with APS were studied for clinical manifestations and serological markers of the disease, as well as the presence of anti-endomysial antibodies using an ELISA assay (EMA-ELISA). Control subjects were 171 healthy individuals, ageand sex-matched (141 females). Eight patients with APS (14%, six females) were found to have EMA-ELISA antibodies, compared with 2/141 (1.1%) of controls (P 0.0003). Antibodies against b2-glycoprotein-I (b2GPI) epitopes (GRTCPKPDDLP) were more prevalent in EMA-positive patients than in EMA-negative patients (P 0.006). Vasculitic skin lesions were significantly more common in EMA-ELISA-positive compared with EMA-ELISA-negative patients (62.5 versus 16.3%, P 0.01). Among the skin manifestations, superficial cutaneous necrosis (37.5 versus 2%, P 0.007) was more prevalent in EMA-ELISA-positive than in EMA-ELISA-negative patients. EMA-ELISA antibodies are common in APS, and their presence is associated with high prevalence of antibodies recognizing certain b2-glycoprotein epitopes, and with cutaneous manifestations of APS.