Background Although sarcoidosis and celiac disease are both chronic
immunologic disorders involving multiple organ systems, reports about
association of diseases in individual patients are sparse. While sarcoidosis
is a chronic granulomatous disease presumably reflecting an exaggerated
response to an unknown antigen, celiac disease is a T cell-driven disease
triggered by ingestion of gluten, a protein composite found in wheat and
related grains. Case presentation We present three cases with a longstanding
history of sarcoidosis that have been additionally diagnosed with celiac-like
enteropathy. In two cases, celiac disease was established applying celiac-
specific serology and duodenal histology, while one case was revealed as an
AIE-75-positive autoimmune enteropathy. The HLA-DR3/DQ2 haplotype was
confirmed in both celiac patients, hence confirming previous data of linkage
disequilibrium as a cause for disease association. Remarkably, one celiac
patient presented with granulomatous nodulae in the ileum, thus reflecting an
intestinal sarcoid manifestation. In contrast the patient with an autoimmune
enteropathy, was HLA-DQ9/DQ6-positive, also arguing against CD. Conclusions
Associations of sarcoidosis and celiac disease are rare but do occur.
Determining the HLA status in patients with complex autoimmune associations
might help classifying involved disease entities
