Background: Celiac disease is an immune-mediated enteropathy triggered by gluten exposure in genetically susceptible individuals and is associated with several autoimmune disorders. However, epidemiological data from Indonesia remain limited. This study aimed to estimate the proportion of celiac disease–related seropositivity among adults with autoimmune diseases and explore potentially associated factors.
Methods: A cross-sectional serological screening study with a nested matched case-control analysis was conducted at Cipto Mangunkusumo National General Hospital, Jakarta, from February to March 2025. Adults aged ≥18 years with established autoimmune diseases who underwent testing for immunoglobulin A antibodies against tissue transglutaminase (anti-tTG IgA) and immunoglobulin G antibodies against deamidated gliadin peptides (anti-DGP IgG) were included. Seropositivity was defined as positive results for both markers. Seropositive participants were matched with seronegative controls by age and sex. Demographic, clinical, comorbidity, and lifestyle data were obtained from medical records. Exploratory bivariate analyses were performed to identify factors associated with celiac seropositivity.
Results: Among 673 patients, 11 were seropositive, corresponding to a hospital-based proportion of 1.63% (95% CI, 0.91%–2.90%). Overall, 89.01% of participants were female, with a mean age of 43.3 years. The most common autoimmune diseases were systemic lupus erythematosus (35.2%), rheumatoid arthritis (16.8%), and Sjögren’s syndrome (14.7%). No statistically significant associations were detected between celiac seropositivity and the evaluated demographic, lifestyle, or clinical variables. However, the small number of seropositive participants limited statistical precision.
Conclusions: Celiac disease–related seropositivity was identified in 1.63% of adults with autoimmune diseases at an Indonesian referral hospital. These findings should not be interpreted as the prevalence of confirmed celiac disease because histopathological confirmation was unavailable. Larger multicenter studies incorporating total IgA measurement, quantitative antibody titres, gluten-exposure assessment, and appropriate diagnostic confirmation are warranted. The clinical value of targeted case-finding in selected high-risk autoimmune populations should also be evaluated.