It can sometimes be difficult to diagnose conditions such as juvenile idiopathic arthritis (JIA) and rheumatoid arthritis (RA), especially because people present such varied symptoms. Earlier identification and diagnosis could help with better outcomes and better symptom management. But how can we contribute to earlier diagnosis? An article in MedScape suggests that paying attention to Celiac disease diagnoses could be helpful.

Celiac disease has previously been associated with other autoimmune conditions such as lupus and type 1 diabetes (T1D). Researchers surmised that some sort of connection between Celiac disease, JIA, and RA might exist. Within this particular study, the research team performed a retrospective study using Sweden’s Epidemiology Strengthened by Histopathology Reports. Ultimately, they identified 24,014 patients with Celiac disease from a 13-year period. The study also used 117,397 matched controls without a Celiac disease diagnosis.

The Findings

Next, the researchers sought to identify how many pediatric patients had JIA and how many adult patients had RA. The findings, published in The American Journal of Gastroenterology, show that:

• Children with Celiac disease were 2.7-3.5x more likely to develop juvenile idiopathic arthritis than their matched controls, even after adjusting for other factors. This increased risk was present in both boys and girls. 
• Adults with Celiac disease were 1.4-1.7x more likely to develop rheumatoid arthritis than their matched controls, even after adjusting for other factors. 
• In adults, the risk of developing rheumatoid arthritis was higher in those who had received a Celiac disease diagnosis between ages 18 to 59. 

While clinical practices often lead to screening those with JIA for Celiac disease, this study suggests bidirectionality. As a result, those with Celiac disease should also be screened for other autoimmune conditions. Additionally, this study suggests that symptoms related to untreated and undiagnosed Celiac disease could spur JIA and RA symptoms.

Juvenile Idiopathic Arthritis (JIA): An Overview

You can learn more about juvenile idiopathic arthritis by simply breaking down the name. Juvenile (“young”) idiopathic (“of unknown origin”) arthritis (“joint inflammation”), then, refers to joint inflammation of an unknown cause in individuals under 18 years old. There are various different types of JIA: oligoarticular, systemic, psoriatic, undifferentiated, enthesitis-related, polyarticular (rheumatoid factor negative), and polyarticular (rheumatoid factor positive). JIA is typically considered to be an autoimmune disorder. 

While there are different forms of JIA, these forms tend to share common symptoms. These symptoms can, but do not always, include:

• Joint pain, swelling, stiffness, and inflammation
  • Note: This often affects the hands, knees, and feet, and is most noticeable after a child has been asleep.
• Limited mobility/range of motion
• Appetite loss
• Dry, gritty eyes
• Blurred vision
• Swollen lymph nodes
• Fever
• Extreme fatigue
• Skin rash
• Eye inflammation (complication)