Abstract
Background—Coexistent primary biliary cirrhosis (PBC) and coeliac disease has been recorded but the association has not been systematically studied. Aims—To determine relative prevalences of PBC and coeliac disease in a defined population over a 12 year period. Patients and methods—All patients with PBC or coeliac disease in a stable population of 250 000 in South Wales were identified from a clinical register and laboratory records. Results—Sixty seven patients with PBC and 143 patients with coeliac disease have been diagnosed and followed over a median of 86 (4-135) months; point prevalences in 1996 were 20 per 100 000 for PBC and 54 per 100 000 for coeliac disease. PBC in patients with coeliac disease was sought by investigating abnormal liver function tests. Ten (7%) had persistent abnormalities and three had PBC. Coeliac disease in patients with PBC was sought by investigating malabsorption, haematinic deficiency, positive antigliadin antibody, or coeliac disease family history. Eleven patients underwent duodenal biopsy revealing one further coeliac disease case. Four patients (three women) have both conditions giving a point prevalence for patients with both conditions of 1.6 per 100 000 (95% confidence limits 0.44 to 4.1 per 100 000). Prevalence of PBC in patients with coeliac disease was 3% and of coeliac disease in patients with PBC was 6%. Conclusion—A 12 year study of a stable 250 000 population revealed a relative prevalence of PBC in 3% of 143 patients with coeliac disease and of coeliac disease in 6% of 67 patients with PBC. PBC and coeliac disease are therefore associated. Screening for PBC in patients with coeliac disease using antimitochondrial antibody testing and screening for coeliac disease in patients with PBC with antigliadin antibody testing or duodenal biopsy are recommended.
Keywords: primary biliary cirrhosis; coeliac disease; prevalence
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Selected References
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- Behr W., Barnert J. Adult celiac disease and primary biliary cirrhosis. Am J Gastroenterol. 1986 Sep;81(9):796–799. [PubMed] [Google Scholar]
- Danielsson A., Boqvist L., Uddenfeldt P. Epidemiology of primary biliary cirrhosis in a defined rural population in the northern part of Sweden. Hepatology. 1990 Mar;11(3):458–464. doi: 10.1002/hep.1840110317. [DOI] [PubMed] [Google Scholar]
- Ginn P., Workman R. D. Primary biliary cirrhosis and adult celiac disease. West J Med. 1992 May;156(5):547–549. [PMC free article] [PubMed] [Google Scholar]
- Hamlyn A. N., Macklon A. F., James O. Primary biliary cirrhosis: geographical clustering and symptomatic onset seasonality. Gut. 1983 Oct;24(10):940–945. doi: 10.1136/gut.24.10.940. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Iliffe G. D., Owen D. A. An association between primary biliary cirrhosis and jejunal villous atrophy resembling celiac disease. Dig Dis Sci. 1979 Oct;24(10):802–806. doi: 10.1007/BF01317215. [DOI] [PubMed] [Google Scholar]
- Logan R. F., Ferguson A., Finlayson N. D., Weir D. G. Primary biliary cirrhosis and coeliac disease: an association? Lancet. 1978 Feb 4;1(8058):230–233. doi: 10.1016/s0140-6736(78)90480-4. [DOI] [PubMed] [Google Scholar]
- Logan R. F., Rifkind E. A., Busuttil A., Gilmour H. M., Ferguson A. Prevalence and "incidence" of celiac disease in Edinburgh and the Lothian region of Scotland. Gastroenterology. 1986 Feb;90(2):334–342. doi: 10.1016/0016-5085(86)90929-7. [DOI] [PubMed] [Google Scholar]
- Myszor M., James O. F. The epidemiology of primary biliary cirrhosis in north-east England: an increasingly common disease? Q J Med. 1990 Apr;75(276):377–385. [PubMed] [Google Scholar]
- Olsson R., Kagevi I., Rydberg L. On the concurrence of primary biliary cirrhosis and intestinal villous atrophy. Scand J Gastroenterol. 1982 Aug;17(5):625–628. doi: 10.3109/00365528209181069. [DOI] [PubMed] [Google Scholar]
- Swinson C. M., Levi A. J. Is coeliac disease underdiagnosed? Br Med J. 1980 Nov 8;281(6250):1258–1260. doi: 10.1136/bmj.281.6250.1258. [DOI] [PMC free article] [PubMed] [Google Scholar]