Reprinted in part with permission from

By Amy Ratner, Director of Scientific Affairs,

Researchers at Columbia University Celiac Center, along with colleagues from two Swedish institutions, found that children with celiac disease were three times as likely to develop juvenile idiopathic arthritis, and adults were twice as likely to be diagnosed with rheumatoid arthritis, compared to the general population. The study involving 24,000 celiac patients, published in the American Journal of Gastroenterology, represents the largest investigation of the association between celiac disease and the two types of arthritis.

As a result of their study, researchers recommended that celiac disease patients with inflammatory joint symptoms be evaluated for juvenile idiopathic arthritis or rheumatoid arthritis. They also found that patients with both celiac disease and juvenile idiopathic arthritis can be more severely affected than those who don’t have celiac disease. In autoimmune arthritis a person’s own immune system attacks their joints, distinguished from osteoarthritis, which is caused by joint mechanical wear and tear.

Both boys and girls with celiac disease had a higher incidence of having juvenile arthritis than the general population, and the increased rate occurred across ages. In adults, women with celiac disease, who made up the majority of those included in the study, had a higher incidence rate of rheumatoid arthritis compared to men with celiac disease and the general public. The study authors noted that while the prevalence of celiac disease in those with juvenile arthritis was previously investigated, few studies have assessed the risk of juvenile arthritis in those who have celiac disease.

The new study’s conclusion that autoimmune arthritis is found more often in children and adults with celiac disease compared to the study’s control groups was consistent when adjusted for multiple socioeconomic factors and other autoimmune diseases. Additionally, some analysis of the children who had been diagnosed with juvenile arthritis led researchers to conclude that the risk seems to increase both before and after a diagnosis of celiac disease making it difficult to determine if a timing relationship between the two conditions exists. Additionally, a separate analysis of adults diagnosed with rheumatoid arthritis found an increased risk of celiac disease compared to the general population.

Celiac disease, juvenile, and rheumatoid arthritis have shared genetic risks, the study says. They also have shared environmental risks, including infections and changes in the gut microbiome, which may lead to increased permeability of the intestine and play a role in developing celiac disease and rheumatoid arthritis. Overall, celiac disease is associated with a number of other autoimmune diseases, with thyroid disease and Type 1 diabetes among the most common.

The study participants came from a largely homogenous Swedish population, so findings are not necessarily generalizable to non-Nordic counties. However, researchers called for future studies to better understand what causes the association between celiac disease and these forms of arthritis and to explore treatment options.

Think you might have celiac disease? For a checklist of symptoms, and further action you can take to be properly diagnosed, visit