Celiac Disease Associated with Alopecia Areata: A multicenter case control study.

Background: Celiac disease (CD) is an autoimmune disorder triggered by the ingestion of gluten, which leads to inflammation and damage to the small intestine. CD is widely associated with various cutaneous disorders, such as Dermatitis Herpetiformis, however, a cross-sectional study with 300 participants conducted by Dev et al¹ hypothesized that it could also be associated with Alopecia Areata (AA).

Objective: This case control study aims to investigate the potential association between Celiac Disease and the prevalence of Alopecia Areata after initial diagnosis.

Methods: Our case control study utilized TriNetX to identify 509,910 patients with Celiac Disease and compared them to 622,747 controls to measure differences in risk outcome for Alopecia Areata.

Results: Our analyses suggests that patients with CD (N=495,211), compared to controls (N=495,112), have an elevated risk in developing Alopecia Areata with an odds ratio of 1.25(1.129-1.385) and p<0.0001.

Limitations: Limitations in this study include analyzing the United States population, potential errors in charting, misdiagnoses, and the erroneous filing of ICD codes to patient charts due to TriNetX utilizing AI to search for patient data.

Conclusion: The large sample size leveraged in this study substantiates an association that was previously suggested but not well established. The compelling degree of association found, even with the possible errors inherent in large, automatically compiled databases, affirms the long suspected association between CD and increased risk of AA.