Co-morbidity of cystic fibrosis and celiac disease in Scandinavian cystic fibrosis patients: ingen

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  • Gjermund Fluge, Norway
  • Hanne Vebert Olesen
  • Marita Giljam, Sweden
  • Peter Meyer, Sweden
  • Tacjana Pressler, Denmark
  • Olav Trond Storrøsten, Norway
  • Ferenc Karpati, Sweden
  • Lena Hjelte, Sweden
  • The Department of Paediatrics

Background: The co-morbidity of cystic fibrosis (CF) and celiac disease (CD) has been reported sporadically since the 1960s. To our knowledge,

this is the first time a systematic screening is performed in a large cohort of CF patients.

Methods: Transglutaminase-IgA (TGA), endomysium-IgA (EMA) and total IgA in serum were measured in 790 CF patients (48% females, 86%

with pancreatic insufficiency). Six patients were diagnosed with CD prior to the study, all receiving a gluten-free diet.

Patients with elevated TGA (N50 Units/mL) and a positive EMA test were offered a gastroscopy obtaining mucosal biopsies from the


Results: Four new cases of CD were diagnosed. Two additional patients had positive serological tests, but normal biopsies.

In total, 10 cases of CD (1.2%, 1:83) indicate a prevalence rate about three times higher than the general prevalence of CD in Norway and

Sweden. No CD patients were detected in the Danish CF cohort.

Patients diagnosed with untreated CD reported symptoms typical of both CF and CD (poor weight gain, loose and/or fatty stools, fatigue,

irritability, abdominal pain). They improved after introduction of a gluten-free diet.

Conclusions: Systematic screening for CD in a Scandinavian cohort of CF patients revealed a higher prevalence of CD than in the general

population. Clinical signs of CD are difficult to differentiate from CF with malabsorption, and patients may go undiagnosed for a long time. In a

population where CD is common we recommend screening for CD in patients with CF.

Original languageEnglish
JournalJournal of Cystic Fibrosis
Pages (from-to)198-202
Number of pages5
Publication statusPublished - 2009

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