Celiac Disease and Your Spleen EP029

Did you know that the spleen plays a leading role in a properly functioning immune system? As the largest organ in your lymphatic system, the spleen spends its time fighting infection and keeping you healthy. Unfortunately, research points to a connection between disorders of the spleen and celiac disease. And if your immune system is already compromised because of gluten damage to your intestines, a spleen issue leaves you at heightened risk for a variety of infections and autoimmune diseases.

Today the Gluten Free RN shares her personal connection to genetic spherocytosis and how spleen damage affected her family. She also covers several studies that document the correlation between spleen issues and celiac disease. Listen in to understand how your spleen functions, the symptoms of spleen disorder, and the autoimmune diseases you may develop if your spleen is damaged or removed.

What's Discussed:

How your spleen works to keep you healthy

• Filters used/damaged red blood cells
• Harvests iron to recycle
• Produces antibodies, white blood cells
• Fights infection
• Vital to immune system

Conditions you may acquire if spleen is damaged (increased risk)

• Pneumonia
• UTI
• Overwhelming sepsis

Instances in which spleen may be enlarged

• Mononucleosis
• Some bacterial infections, metabolic disorders
• Liver diseases
• Some blood cancers, lymphoma
• Blood clots in veins of liver, spleen

Symptoms of spleen issues

• Pain in upper left quadrant
• Fatigue
• Anemia
• Bruise easily
• Bloated

The correlation between genetic spherocytosis and celiac disease

• As high as 88% in some studies

How the ratio of spleen diameter to RDW can indicate celiac disease

• Two-thirds of celiac patients in study had elevated red blood cell distribution width
• Small spleen in 80% of celiac patients
• Spleen diameter to RDW ratio under 6 had 88.5% specificity in predicting celiac disease

Why patients with hyposplenism should get tested for celiac disease

• 25-75% of celiac patients have hyposplenism
• Look for red blood cell abnormality
• HLA-DQ2 and HLA-DQ8 genes indicate predisposition for celiac disease
• Antibody test available from EnteroLab or Cyrex Laboratories
• Ask for total IgA, IgG

Other autoimmune diseases patients with hyposplenism may develop (increased risk)

• Type 1 diabetes
• Lupus
• Sjögren's syndrome
• Vitiligo
• Raynaud's
• Autoimmune thyroiditis
• ALS, MS, any demyelination of nervous system
• Idiopathic thrombocytopenia
• Autoimmune hepatitis

Nadine's recommendations around nutrition

• Local, organic
• Nutrient dense
• Gluten-free, Paleo

The link between hyposplenism and autoimmune manifestations of celiac disease

• Autoimmune disorders may cause splenic hypofunction or vice versa
• Study hypothesizes that higher risk for splenic function in celiac patients may be related to celiac disease rather than autoimmunity
• Prevalence of celiac disease-associated hyposplenism increased from 19% in uncomplicated patients to 59% in those with autoimmune disorders

Why celiac patients may not benefit from iron supplements, infusions

• Damaged intestines cannot absorb iron
• Damaged spleen destroys healthy red blood cells

Resources:

"Ratio of Spleen Diameter to Red Blood Cell Distributions Width" in Medicine (Baltimore)

EnteroLab

Cyrex Laboratories

"Is it Worth Investigating Splenic Function in Patients with Celiac Disease?" in the World Journal of Gastroenterology

"Hyposplenism in Gastrointestinal Disease" in Gut BMJ

"Hyposplenism, Adult Coeliac Disease, and Autoimmunity" in Gut BMJ

"Splenic Volume Differentiates Complicated and Non-Complicated Celiac Disease" in UEG Journal

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Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism