Celiac disease is known to be what is called an autoimmune disease, which occurs when the body attacks itself. After gluten exposure in certain individuals, a type of cell called a T cell starts to damage the small intestine. T cells are part of the immune system, which is supposed to protect people from infectious illness and cancer. Sometimes, as in celiac disease, this system makes a mistake, and targets normal parts of the body.
Antibodies directed at gluten and parts of the intestine are made by patients with celiac disease. Antibodies are chemicals which are also supposed to defend against germs, but in this case, are mistakenly aimed at normal substances in the intestine. Patients with celiac disease have antibodies to parts of gluten, to certain tissue in the intestine, and to an enzyme that makes gluten more interesting to the T cells. These antibodies can be measured and used to diagnose gluten intolerance. The two antibodies measured most often are anti-endomysial antibodies and anti-tissue transglutaminase antibodies (anti-EMA and anti-tTG).
It is thought that there are a number of things that have to happen to a person before he or she develops celiac disease. Once these occur, the body’s immune system is activated. There are many other autoimmune diseases in addition to celiac disease. People with one of them are more likely to come down with another. They also tend to run in families.
Over the years doctors have found more autoimmune diseases in patients with celiac disease than in patients without any other autoimmune conditions. People with celiac disease are more likely to have low thyroid hormone, a condition called hypothyroidism. This is frequently the result of an autoimmune disease which destroys thyroid tissue so it cannot make enough thyroid hormone.
Insulin-dependent diabetes is also more common in people with celiac disease. Among other autoimmune disorders more common in patients with celiac disease are conditions in which there is damage to nerves and the liver.
People with celiac disease also can experience number of skin disorders which are thought to be autoimmune in nature. These include a loss of skin pigmentation, a loss of hair, and psoriasis.
Since autoimmune disorders run in families, it is reasonable to expect that there might be more cases of these in close relatives (parents, children, brothers and sisters) of people with celiac disease. There is more diabetes in close relatives of people who are gluten intolerant. There are also more cases of a specific childhood joint illness. Many of the other diseases noted above are also more common in close relatives of people with celiac disease.
Knowing that patients with celiac disease may have these other conditions is important for three reasons. One is that it increases the chance that a disease like low thyroid might be diagnosed earlier in celiac patients. Doctors should check patients with celiac disease for low thyroid and diabetes. Similarly, doctors treating patients for low thyroid or diabetes should think about celiac disease in patients with symptoms suggestive of gluten intolerance.
Secondly, it is possible that treating the celiac disease may prevent or improve some of the other illnesses. Eliminating gluten from the diet has been found to improve the skin conditions.
Finally, the knowledge helps increase the understanding of autoimmune diseases in general and celiac disease in particular. Research continues attempting to find the genetic roots of all of these illnesses.
Autoimmune Disease: is a disease in which the body attacks its own tissues. Some of the most common of these are rheumatoid arthritis and systemic lupus erythematosus.
T cells: Part of the immune system that can attack bacteria as well as normal human cells if something has triggered an autoimmune disease.
Antibodies: Substances made to fight off infection. These are always made in autoimmune diseases. Often the diagnosis of an autoimmune disease is made by measuring these antibodies.
Gliadins and Glutenins: pieces of gluten that the body reacts to. People with celiac disease have antibodies against gliadins.