A patient with celiac disease may develop or present with an arthropathy.
Features of joint involvement:
(1) monoarthritis
(2) oligoarthritis
(3) polyarthritis
The patient may be known to have celiac disease but sometimes may initially present with the arthritis. Celiac disease should be suspected if there is a concurrent:
(1) malabsorption
(2) unexplained iron deficiency anemia
(3) dermatitis herpetiformis
The diagnosis may be complicated if the patient has a concurrent autoimmune disease such as rheumatoid arthritis or SLE. In these cases the person may not respond as expected to therapy directed against these conditions.
The diagnosis is supported by improvement in the arthritis on a gluten-free diet and relapse on re-exposure to gluten.
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