Food intolerance in rheumatoid arthritis.

Sir: We read with interest the two papers by Drs van de Laar and van der Korst on food intolerance in rheumatoid arthritis (RA).1 2 It appears from this extensive but short study of patients with seropositive RA that rheumatoid disease in a small subgroup is sensitive to dietary manipulation. Identification of these patients is, however, a problem. We have previously shown that significant gut abnormalities are associated with raised levels of IgA rheumatoid factor (RF) and dietary protein specific IgG in patients with RA and suggested that these changes might identify patients who would respond to dietary manipulation.3 Gendre and colleagues have described villous atrophy and other histological abnormalities of the small intestine in patients with RA.4 These changes were more significant among IgM RF negative patients (who are often IgA RF