Fibromyalgia and coeliac disease: a media hype or an emerging clinical problem?

CER6217
2013 Vol.31, N°6 ,Suppl.79
PI 0050, PF 0052
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PMID: 24021167 [PubMed]

Received: 23/12/2012
Accepted : 27/05/2013
In Press: 09/09/2013
Published: 16/12/2013

Abstract

OBJECTIVES:
Fibromyalgia (FM) association with autoimmune diseases has been widely reported in literature. Coeliac disease (CD) is a small intestine immune-mediated disorder triggered by gluten ingestion in genetically predisposed patients. In recent years, the Internet and the non-medical press have reported a correlation between gluten-related disorders and fibromyalgia-like symptoms. The aim of our study was to verify a possible association between FM and CD, by assessing the prevalence of CD in a cohort of FM patients and vice versa.
METHODS:
90 consecutive subjects from our Rheumatologic outpatient clinic who had been diagnosed with FM were serologically tested for CD and positive patients underwent esophagogastroduodenoscopy to obtain duodenal biopsies. A second group of 114 consecutive subjects from our Coeliac Disease outpatient clinic were investigated for the presence of FM-like symptoms through a questionnaire. Patients reporting chronic widespread pain were addressed to a rheumatologist for further evaluation.
RESULTS:
The overall prevalence of CD in our FM patients was identical to that expected in general population (around 1%). In our CD group 17 patients (14.9%) reported chronic widespread pain at the questionnaire and 13 (11.4%) satisfied ACR 1990 criteria for FM. Their symptoms had not been modified by GFD.
CONCLUSIONS:
A serological screening for CD is not recommended in FM patients but rather a case-finding strategy should be performed. At the same time, proposals of GFD in FM patients, in absence of a well-established diagnosis of CD, should be rigorously avoided.