Anorexia, coeliac and autoimmune disease

We usually think of anorexia nervosa (AN) and other eating disorders (ED) as primarily psychological conditions. However there is a surprising amount of evidence suggesting that autoimmunity has something to do with it. Some autoantibodies can have a direct effect on brain neurons causing obvious behavioural disorders, as a seen in PANDAS (paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections): indeed some PANDAS-type cases have been reported to have acute-onset anorexia.

Two large population based studies from Scandinavia throw some light on this puzzling association. The first, from Sweden, used their national registers to link people with intestinal biopsies that were unequivocally positive for coeliac disease (CD) with a formal diagnosis of AN (by ICD-8, 9 or 10 criteria), before or after the CD diagnosis (Mårild K et al. Pediatrics 2017. doi:10.1542/peds.2016-4367). Nearly 18 000 CD cases (median age at diagnosis 28 years) were compared with 90 000 matched...

from Archives of Disease in Childhood current issue http://ift.tt/2ocbTFY