Coeliac disease (CD) is an autoimmune disorder of the small intestine with highly variable clinical presentation, frequently associated with various diseases and conditions, autoimmune and non-autoimmune.
We aimed to study the association of childhood CD and atopic dermatitis (AD) in Estonia studying the frequency of AD cases in newly diagnosed CD patients and CD cases in active AD.
Methods We investigated 152 consecutive children with CD (45% boys, mean age 2.3 years) and 351 consecutive children with AD (57% boys, mean age 5.8 years). CD diagnosis was made according to the ESPGHAN diagnostic criteria and AD was diagnosed by UK Working Party’s Diagnostic Criteria for AD.
Results Among CD patients, AD was diagnosed in 8 (5.3%) children, and in the AD group CD was confirmed in 5 (1.4%) patients. All patients with both diseases had histologically characterised small intestinal damage as Marsh IIIa-IIIc stages, two of them had silent CD. The risk for developing CD was revealed to be four times higher in AD patients (OR = 4.18; 95% CI: 1.12–15.64) when compared to general children population in Estonia (frequency 0.34%; Lillemäe et al ., Eur J Gastroent Hepatol 2012). Two patients with CD and AD had no symptoms to suspect CD, in spite of extensive histological changes in small intestinal mucosa.
Conclusions CD and AD coexist more frequently than could be expected. Therefore, our study emphasises the need for evaluating the cost-effectiveness for CD screening of AD patients alongside with other immune-mediated diseases in order to diagnose CD in time.