Document Detail

Evidence of gastrointestinal immune reactivity in patients with sarcoidosis.
MedLine Citation:
PMID:  10363754     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The aim of the present study was to explore the frequency of clinical and serological manifestations of gastrointestinal immune reactivity in a large group of Swedish patients with sarcoidosis. DESIGN: In patients with documented sarcoidosis, the presence of pernicious anaemia and coeliac disease was examined. Antibodies to H+/K+ ATPase, gliadin (AGA-IgA/IgG) and endomysium (IgA-EMA) were analysed. In H+/K+ ATPase antibody-positive patients, serum gastrin levels were measured and, when elevated, gastrointestinal biopsy was offered (biopsy performed in 6/9 patients): biopsy was also offered to those with positive EMA or AGA of either class (biopsy performed in 8/12 patients). Subjects from national and local studies were used as controls. SETTING: The patients were recruited at the Department of Pulmonary Medicine, and the study was conducted at the Department of Endocrinology, University of Lund, Malmö University Hospital, Malmö, Sweden. SUBJECTS: Of all patients (n = 89) with documented sarcoidosis attending the Department of Pulmonary Medicine between January 1980 and December 1991, 78 [34 females and 44 males; median age at the time of the study, 48 (range 22-81) years; median observation time since the diagnosis of sarcoidosis, 120 (range 1-468) months] were examined. RESULTS: Twenty-nine patients (37.2%) had signs of gastrointestinal immune reactivity. H+/K+ ATPase antibodies were detected in 19 patients (24.4 vs. 4% in controls, P = 0.00015). Serum gastrin levels (median 45, range 22-720 pmol L(-1)) in those patients correlated with antibody titre (r2 = 0.882). Gliadin antibodies were detected in 12 patients (15.4 vs. 8.1% in controls, P = 0.042), of whom 11 (14.1 vs. 4.5% in controls, P = 0.00114) had AGA-IgA alone. One patient had pernicious anaemia and another coeliac disease (EMA-positive). CONCLUSION: We have demonstrated a high frequency of gastric autoimmunity and gluten-associated immune reactivity in patients with sarcoidosis, occurring in almost 40% of the cases, the former being the most frequent gastrointestinal immune manifestation. Despite a high frequency of humoral autoimmunity, the frequencies of clinical disease, pernicious anaemia and coeliac disease were not increased as compared with the control population.
K I Papadopoulos; K Sjöberg; S Lindgren; B Hallengren
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of internal medicine     Volume:  245     ISSN:  0954-6820     ISO Abbreviation:  J. Intern. Med.     Publication Date:  1999 May 
Date Detail:
Created Date:  1999-06-17     Completed Date:  1999-06-17     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8904841     Medline TA:  J Intern Med     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  525-31     Citation Subset:  IM    
Department of Endocrinology, University of Lund, Malmö University Hospital, Sweden.
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MeSH Terms
Aged, 80 and over
Anemia, Pernicious / immunology*
Autoantibodies / blood*
Celiac Disease / immunology*
Digestive System / immunology*
Gliadin / immunology
H(+)-K(+)-Exchanging ATPase / immunology
Middle Aged
Muscle Fibers, Skeletal / immunology
Sarcoidosis / epidemiology,  immunology*
Sweden / epidemiology
Reg. No./Substance:
0/Autoantibodies; 9007-90-3/Gliadin; EC ATPase

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