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Rheumatology International

, Volume 30, Issue 4, pp 455–460 | Cite as

Back pain and sacroiliitis in long-standing adult celiac disease: a cross-sectional and follow-up study

  • Edit Vereckei
  • Ádám Mester
  • László Hodinka
  • Péter Temesvári
  • Emese Kiss
  • Gyula Poór
Original Article

Abstract

There have been only scattered reports suggesting that musculoskeletal manifestations including back pain and sacroiliac joint involvement may be associated with celiac disease. In order to confirm this issue in a larger cohort, rheumatic manifestations were analyzed in 21 adult celiac patients using a comprehensive clinical, laboratory and radiological analysis. The diagnosis of celiac disease was based on the histopathology of jejunal biopsy specimens. The mean duration of celiac disease was 15 (0–31) years. All patients were currently on gluten-free diet and none of the patients had gastrointestinal symptoms at the time of the study. Using various imaging techniques, involvement of the sacroiliac joints was confirmed in 70% of celiac patients. Imaging revealed different morphological changes in the sacroiliac joint, e.g. accumulation of synovial fluid, synovitis, erosion with concomitant sclerosis, sacroiliitis or calcification of the ligament. These changes probably represent different clinical stages and/or manifestations of the same process. In a follow-up study of eight patients, after 11 years on a gluten-free diet, the great majority of patients had no clinical symptoms; yet, a subclinical progression of the sacroiliac joint involvement could be verified. Our results suggest the importance of regular rheumatologic follow-up of patients with celiac disease.

Keywords

Celiac disease Sacroiliac joint involvement Back pain Comprehensive radiological analysis Follow-up study 

Notes

Acknowledgments

We are greatly thankful to Professor Zoltan Szekanecz for his kind remarks and advice based on his expert opinion.

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Edit Vereckei
    • 1
  • Ádám Mester
    • 1
  • László Hodinka
    • 1
  • Péter Temesvári
    • 1
  • Emese Kiss
    • 1
  • Gyula Poór
    • 1
  1. 1.National Institute of Rheumatology and PhysiotherapyBudapestHungary

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