In the Journals

Celiac disease patients prone to develop fibromyalgia

While patients with celiac disease had more than a 10% chance of developing fibromyalgia, patients with fibromyalgia had the same prevalence of celiac disease as the general population, according to recent study results.

Researchers in Italy analyzed 90 rheumatology clinic patients diagnosed with fibromyalgia (FM; median age, 56 years; 79 women) who received serological testing for celiac disease (CD). Patients who tested positive received esophagogastroduodenoscopy to obtain duodenal biopsies. One hundred fourteen patients (median age, 36 years, 93 women) from an outpatient CD clinic were studied for the presence of FM-like symptoms using a four-item questionnaire. Patients who reported chronic widespread pain were referred to a rheumatologist for further diagnosis and FM confirmation.

One FM patient was diagnosed with CD, with the overall CD prevalence among the FM patients (1.1%) identical to the expected prevalence in the general population. Seventeen CD patients (14.9%) reported chronic pain in the questionnaire, with 13 patients (11.4%) meeting the American College of Rheumatology 1990 criteria for FM. Patients diagnosed with fibromyalgia reported that a gluten-free diet (GFD) had little or no benefit for reducing symptoms.

“Our study shows that CD patients are prone to develop fibromyalgia, but, conversely, prevalence of CD in patients with FM is not increased in comparison with the general population,” the researchers concluded. “Consequently, a serological screening for CD is not recommended in FM patients, but rather a case-finding strategy should be performed in selected cases of FM with concomitant signs or symptoms suggestive for CD.

“At the same time, proposals of GFD in FM patients, in absence of a well-established diagnosis of CD, should be rigorously avoided.”

Disclosure: The researchers report no relevant financial disclosures.