Juvenile chronic arthritis and coeliac disease in the Netherlands

Objective. It has been suggested that juvenile chronic arthritis (JCA) is associated with coeliac disease in a frequency of 0.4-2%. In order to investigate the frequency of coeliac disease in cases of JCA and the possibility of underdiagnosis in our area, we screened 62 children with JCA (mean age 9.8 +/- 3.5 year) for coeliac disease. Methods. All children were screened for coeliac disease by measuring the IgA-class of antigliadin, antireticulin and antiendomysium antibodies in serum and by measuring intestinal permeability by a sugar absorption test using lactulose and mannitol. In cases of at least one positive test, a small-bowel biopsy for diagnosis of coeliac disease was offered. Results. Of the 62 children with JCA, 8 had an abnormal screening result and were suspected of having coeliac disease. In four of the five children in whom a small-bowel biopsy was performed, the intestinal mucosa was normal and in one child villous atrophy characteristic of coeliac disease was found. Therefore, the prevalence of coeliac disease in our study group was 1.5%, which is in agreement with the literature. Conclusion. These findings indicate no underdiagnosis of coeliac disease in JCA in our area.