Sunday, September 6, 2009

Celiac Disease and Associated Autoimmune Diseases: The Connection

People who have celiac disease (CD) or dermatitis herpetiformis (DH) are at greater risk than the general population for developing one or more of the associated autoimmune diseases listed below. These disorders share common genetic and immunological linkages with CD and DH. Although these conditions are not directly a result of having CD or DH, the tendency to develop associated immune diseases is higher in persons with celiac disease and dermatitis herpetiformis. The tendency to develop autoimmune diseases is believed to be genetically influenced. In an autoimmune disorder, the cells of the immune system produce antibodies and other cellular products that begin to react against normal, healthy tissue, causing inflammation and damage. This is not a complete listing of autoimmune diseases associated with CD and DH. Anyone who has unexplained, persistent or recurring symptoms should consult a qualified physician for an evaluation.

Addison’s Disease
A rare disease involving the adrenal gland. The prevalence of CD in persons with Addison’s Disease is significant. Symptoms of Addison’s may include weight loss, increasing fatigue, lack of appetite, anemia, darkening of the skin, increased sun sensitivity, low blood sugar, low blood pressure, nausea, vomiting, diarrhea or constipation, and dehydration.
Autoimmune Chronic Active Hepatitis
A disease of the liver that may be mistaken for alcoholic liver disease. Seventy percent of patients are female. Symptoms can include fatigue, abdominal discomfort, itching, nausea, vomiting, bloating, yellowing of the skin and whites of the eyes (jaundice), enlarged liver, tumors on the skin, aching, fever, mental confusion, and cirrhosis.
Insulin Dependent Diabetes Mellitus (Type 1)
A disease of the pancreas. The incidence of Type 1 diabetes and CD is between 6- 12%. Often the second disease is silent (having few symptoms). Symptoms can include excessive thirst, hunger, weakness, frequent urination, blurred vision, trembling, confusion, weight loss, and coma (if left untreated).
Myasthenia Gravis
A disease involving muscle function in which nerve impulses to the muscles are impaired. Sixty-six percent of patients are female. Symptoms can include rapid fatigue and muscle weakness, especially as the day progresses, high-pitched voice, difficulty swallowing, droopy eyelids, unsteady or waddling gait, double vision, enlarged thymus gland.
Pernicious Anemia
Also known as vitamin B-12 deficiency. In pernicious anemia the lining of the stomach is damaged, causing a deficiency of intrinsic factor. Intrinsic factor is required to absorb vitamin B-12. Symptoms can include fatigue, sore tongue, yellow skin, tingling hands and feet, depression, memory loss, difficulty with balance, shortness of breath, and occasionally heart palpitations.
Raynaud’s Phenomenon
Often seen in combination with other autoimmune diseases, such as lupus, rheumatoid arthritis, or Sjogren’s. It affects the blood vessels. Symptoms may include abnormal sensitivity to the cold, hands or feet change colors from white, purple, or blue to red, and painful spasms with exposure to cold.
Scleroderma
Scleroderma can affect the skin, GI tract, muscles, lungs, or kidneys. It causes scar tissue (fibrosis) to form in skin and organs. Eighty percent of patients are female. Symptoms may include tight, leathery skin, red and swollen fingers, severe indigestion, heartburn, constipation, diarrhea, muscle pain, weakness and shortness of breath.
Sjogren’s Syndrome
A disease involving the mucus-secreting glands that causes a reduction of excretions. This can cause dryness of the eyes, mouth, vagina, skin, lungs, brain, sinuses, blood cells, blood vessels, digestive tract, bladder, kidneys and joints. Ninety percent of patients are female. Symptoms may include painful dry eyes, dry mouth, sores in the mouth, on the tongue or throat, gum inflammation, tooth decay, tooth loss, dry skin, rashes, vaginal dryness, yeast infections, shortness of breath, pleuritis, pericarditis, diarrhea, constipation, abdominal pain, chronic sinusitis, confusion, numbness or tingling in the hands or feet, seizures, stroke, kidney disease, fatigue, joint and/or muscle pain, vasculitis or blood clots.
Systemic Lupus Erythematosus
Lupus can affect many organs: the skin, joints and muscles, kidneys, heart, brain, lungs, blood and blood vessels, intestines, hearing and balance. Ninety percent of patients are female. Symptoms vary depending on the organs involved, but may include fatigue, fever, anemia, rashes in sun-exposed areas, aching muscles, painful and stiff joints,confusion, seizures, inflammation around the heart or lungs, sores in the mouth, vasculitis, blood clots, and changes in the urine.
Thyroid Disease
There are two common forms of autoimmune thyroid disease commonly associated with CD and DH - Grave’s disease and Hashimoto’s disease.
Grave’s Disease: An overaactive thyroid. Symptoms may include weight loss, rapid pulse, protruding eyes, feeling too warm, restlessness, insomnia, diarrhea, irritability, palpitations.
Hashimoto’s Disease: An underactive thyroid. Symptoms may include weight gain, slow pulse, red puffy eyes, feeling too cold, mental slowness, drowsiness, confusion, constipation, enlarged thyroid gland in the neck, thick and coarse hair.

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