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Gluten-Free Diet in Juvenile Idiopathic Arthritis

K Aalto, P Lahdenne, KL Kolho

Aim: Gluten-free diet may attenuate joint symptoms in adult rheumatoid arthritis. We conducted a groundwork study on the effect of a gluten-free diet in children with arthritis.

Methods: 4 children (aged 5-12) with juvenile idiopathic arthritis (JIA) were recruited for a study including 3 months on a gluten-free diet. Articular symptoms and signs, and the presence of antibodies to gliadin, endomysium, transglutaminase, and milk were determined at 0, 3, and 6 months as well as immunoglobulins, blood count, ESR, CRP and markers for intestinal inflammation, alpha-1-antitrypsin, physician’s and patient’s VAS, a CHAQ-form, and JADAS10.

Results: In a 5-year old boy articular and gastrointestinal symptoms improved during gluten-free diet. A 12-year old girl experienced some relief and disease activity scores showed moderate improvement. In two other patients the objective measurements were unaltered. In one of these two, antigliadin-IgG and milk-IgA antibodies remained elevated throughout the study.

Conclusions: Results of this small prospective study on gluten free diet in patients with JIA were inconclusive although some subjective improvement was observed. A more extensive study including patients with more active disease seems warranted.