Celiac disease and multiple sclerosis in the northwest of Iran

Abstract

Objective: To compare the frequency of celiac disease (CD) in patients with multiple sclerosis (MS) and healthy controls using tissue transglutaminase IgA antibodies (anti-tTGA) as a screening tool.

Background: CD and MS are immune-mediated diseases, and it has been hypothesized that the genetic similarities between these conditions can predispose individuals to suffer from both. Data regarding this association are limited, particularly in Eastern countries.

Methods: One hundred clinically defined MS patients were randomly selected from Tabriz, northwest of Iran. The control group consisted of 121 age- and gender-matched healthy individuals. All subjects were screened with anti-tTGA. Total IgA was obtained for investigation of IgA deficiency.

Results: The mean age of MS patients (32 male and 68 female) was 33.06±8.79 years; the mean age of controls was 32.98±9.62 years. The mean expanded disability scale score (EDSS) for MS patients was 3.86±1.91. Approximately 78.5 % of MS patients suffered from a remitting relapsing type of MS. All subjects (MS patients and controls) were negative for anti-tTGA. IgA deficiency was demonstrated in 14 % of MS patients and 11 % of controls (p>0.1). No IgA-deficient subjects consented to undergo a duodenal mucosa biopsy.

Conclusion: The present study failed to demonstrate a positive relationship between MS and CD. Therefore, we conclude that there is no basis for recommending the routine screening of MS sufferers for celiac disease (Ref. 23).