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Anorexia, coeliac and autoimmune disease

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We usually think of anorexia nervosa (AN) and other eating disorders (ED) as primarily psychological conditions. However there is a surprising amount of evidence suggesting that autoimmunity has something to do with it. Some autoantibodies can have a direct effect on brain neurons causing obvious behavioural disorders, as a seen in PANDAS (paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections): indeed some PANDAS-type cases have been reported to have acute-onset anorexia.

Two large population based studies from Scandinavia throw some light on this puzzling association. The first, from Sweden, used their national registers to link people with intestinal biopsies that were unequivocally positive for coeliac …

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