Cardiolipin Antibodies in Biopsy-defined Adult Celiac Disease

Cardiolipin antibodies have been considered to be a hallmark or marker of the antiphospholipid syndrome, a disorder associated with an increased risk of cerebrovascular events and pregnancy loss.Prior studies have shown increased cardiolipin antibodies in celiac disease, and even higher in some studies of treated celiac disease with a gluten-free diet.Still, limited clinical follow-up in these studies did not permit exploration of an increased risk of cardiovascular events.This study explored this paradigm in 28 celiac disease patients, treated with a gluten-free diet, defined by histopathological evidence of normalization of small intestinal mucosa.Here, in celiacs on a lifelong gluten-free diet, no increased cardiovascular risk, as reflected in clinically evident thrombotic or embolic events, was identified despite follow-up for up to 34 years.Cardiolipin antibodies in gluten-free diet treated celiac disease could represent a marker of risk, but this was defined here despite long-term clinical follow-up over many decades.