Celiac Awareness Makes a Difference for Rheumatology Patients

Diagnosis Challenges
Any physician familiar with celiac disease knows that identifying gluten sensitivity is not always clear. Symptoms of celiac disease vary widely and may include:

• Anemia;
• Fatigue;
• Malnutrition or vitamin deficiency;
• Anxiety;
• Depression;
• Attention deficit/hyperactivity disorder;
• Migraine;
• Irritability;
• Abdominal pain;
• Acid reflux;
• Lactose intolerance;
• Arthritis;
• Bone or joint pain;
• Infertility; and
• Eczema.⁵

Dr. Chen has patients who demonstrate symptoms of gluten sensitivity, but who test negative for celiac disease. She also has patients who come to her with an autoimmune disease and demonstrate no typical symptoms of celiac, yet test positive for celiac disease. “We can only practice based on the evidence, and it is lacking in celiac [disease] research to help patients get a definitive diagnosis,” she says.

She hopes this will change. Dr. Chen will be speaking with a panel of celiac disease experts at the 2018 ACR/AHRP Annual Meeting this fall. She hopes this discussion will fuel a dialogue and research on celiac diagnostics and treatments.

“We need to join forces and begin connecting the dots through patient stories, family histories and the development of better diagnostics to uncover the true impact of celiac [disease],” Dr. Chen says. “With a clearer understanding of celiac disease, we can target our treatment plans and communications with patients to help them experience improved health and well-being.”

Carina Stanton is a freelance science journalist in Denver.

 References

1. University of Chicago School of Medicine Celiac Disease Center. Celiac disease facts and figures. 2018.
2. Ventura A, Magazzù G, Greco L. Duration of exposure to gluten and risk for autoimmune disorders in patients with celiac disease. SIGEP Study Group for Autoimmune Disorders in Celiac Disease. Gastroenterology. 1999 Aug;117(2):297–303.
3. Krysiak R, Szkróbka W, Okopień B. The effect of gluten-free diet on thyroid autoimmunity in drug-naïve women with Hashimoto’s thyroiditis: A pilot study. Exp Clin Endocrinol Diabetes. 2018 Jul 30.
4. Celiac Disease Foundation. Understanding celiac disease: What is celiac disease? 2018.
5. Celiac Disease Foundation. Understanding celiac disease: Celiac disease symptoms. 2018.