Non-celiac wheat sensitivity and ANA positivity: is there any association with autoimmune disease?

Introduction: In the last decade non-celiac wheat sensitivity (NCWS) has raised great interest but unfortunately little is known about the risks linked to this condition. Our study aimed to evaluate the frequency of autoimmune diseases (AIDs) and of serum anti-nuclear antibodies (ANA) in these patients. Materials and Methods: We recruited 131 NCWS patients (121 F, mean age 39.1 years), belonging to a historical cohort retrospectively evaluated, at two Internal Medicine Institutes. Two groups of age- and sex-matched controls, respectively composed of celiac (CD) and irritable bowel syndrome (IBS) patients, were also chosen. Co-existent of AIDs was recorded by a pre-structured questionnaire. ANA titers were evaluated by immuno-fluorescence. Results: Positivity for serum ANA was proved in 46% of NCWS (median titer 1:80), in 24% of CD (P<.000l) and in 2% of IBS (P<.0001) cases. An association between ANA positivity and the presence of the DQ2/DQ8 haplotypes and with the presence of duodenal lymphocytosis was found. AIDs were identified in 29% of NCWS patients (Hashimotos thyroiditis 29 cases, psoriasis 4 cases, type 1 diabetes 4 cases, mixed connective tissue disease 1 case, ankylosing spondylitis 1 case), in 21% of CD (not statistically significant) subjects and in 4% of IBS controls (P<.0001). Conclusions: We pointed-out a strong tendency towards autoimmunity in the NCWS patients, characterised by both associated AIDs and serum ANA positivity and raised the question of an overlap between NCWS and CD.