Is there an association between familial Mediterranean fever and celiac disease?
Abstract
Familial Mediterranean fever (FMF) and celiac
disease (CD) shares some clinical features such as
abdominal pain, diarrhea, arthralgia, and arthritis. Furthermore, both diseases are related to several inflammatory
disorders. Based on these analogies, we have investigated
whether there is any relationship between CD and FMF.
The study had two groups. Group I: 50 children with FMF
were questioned and examined for the evidence of CD, serum
immunoglobulin A (IgA) levels, antigliadin antibodies
(AGA) IgA, AGA IgG, and anti-endomysial antibodies
(EMA) IgA were tested, and intestinal biopsy was performed
when necessary. Group II: 17 children with CD were
evaluated for the presence of clinical and laboratory features
of FMF and mutation analysis for MEFV gene was performed
to all of them. Six predominant mutations (p.M694V, p.
M680I, p.M694I, p.V726A, p.K695R, p.E148Q) in the
MEFV gene were studied. The results were as follows—
group I: three patients had diarrhea, six had abdominal pain,
one had positive AGA IgA, six had AGA IgG, and one had
EMA IgA. Intestinal biopsy was performed in one patient
who was normal, so none of the patients with FMF were
diagnosed as CD and group II: none of the patients with CD
had complaints consistent with FMF. Four of the 17 patients
(23.5%) were found to carry MEFV mutations. Three of
them had heterozygous p.E148Q mutation and one of them
had heterozygous p.M680I mutation. None of the FMF
patients had CD. MEFV mutation frequency in patients with
CD was similar to the normal population in Turkey. Our
study did not reveal any association between CD and FMF