OBJECTIVE: To establish whether children who are endomysial antibody (EmA) positive and have normal small-bowel mucosal villous morphology are truly gluten-sensitive and may benefit from early treatment with a gluten-free diet. STUDY DESIGN: Children who were EmA positive with normal small-bowel mucosal villi were compared with children who were seropositive with villous atrophy by using several markers of untreated celiac disease. Thereafter, children with normal villous structure either continued on a normal diet or were placed on a gluten-free diet and re-investigated after 1 year. Seventeen children who were seronegative served as control subjects for baseline investigations. RESULTS: Normal villous morphology was noted in 17 children who were EmA positive, and villous atrophy was noted in 42 children who were EmA positive. These children were comparable in all measured variables regardless of the degree of enteropathy, but differed significantly from the seronegative control subjects. During the dietary intervention, in children who were EmA positive with normal villi, the disease was exacerbated in children who continued gluten consumption, whereas in all children who started the gluten-free diet, both the gastrointestinal symptoms and abnormal antibodies disappeared. CONCLUSIONS: The study provided evidence that children who are EmA positive have a celiac-type disorder and benefit from early treatment despite normal mucosal structure, indicating that the diagnostic criteria for celiac disease should be re-evaluated. Copyright (c) 2010 Mosby, Inc. All rights reserved.
OBJECTIVE: To establish whether children who are endomysial antibody (EmA) positive and have normal small-bowel mucosal villous morphology are truly gluten-sensitive and may benefit from early treatment with a gluten-free diet. STUDY DESIGN:Children who were EmA positive with normal small-bowel mucosal villi were compared with children who were seropositive with villous atrophy by using several markers of untreated celiac disease. Thereafter, children with normal villous structure either continued on a normal diet or were placed on a gluten-free diet and re-investigated after 1 year. Seventeen children who were seronegative served as control subjects for baseline investigations. RESULTS: Normal villous morphology was noted in 17 children who were EmA positive, and villous atrophy was noted in 42 children who were EmA positive. These children were comparable in all measured variables regardless of the degree of enteropathy, but differed significantly from the seronegative control subjects. During the dietary intervention, in children who were EmA positive with normal villi, the disease was exacerbated in children who continued gluten consumption, whereas in all children who started the gluten-free diet, both the gastrointestinal symptoms and abnormal antibodies disappeared. CONCLUSIONS: The study provided evidence that children who are EmA positive have a celiac-type disorder and benefit from early treatment despite normal mucosal structure, indicating that the diagnostic criteria for celiac disease should be re-evaluated. Copyright (c) 2010 Mosby, Inc. All rights reserved.
Authors: Luke Forde; Niamh McGrath; Deirdre Devaney; Sami Awadalla; Ciara M McDonnell; Nuala P Murphy Journal: Ir J Med Sci Date: 2018-05-31 Impact factor: 1.568
Authors: Edwin Liu; Fran Dong; Anna E Barón; Iman Taki; Jill M Norris; Brigitte I Frohnert; Edward J Hoffenberg; Marian Rewers Journal: Gastroenterology Date: 2017-02-07 Impact factor: 22.682
Authors: Jonas F Ludvigsson; Daniel A Leffler; Julio C Bai; Federico Biagi; Alessio Fasano; Peter H R Green; Marios Hadjivassiliou; Katri Kaukinen; Ciaran P Kelly; Jonathan N Leonard; Knut Erik Aslaksen Lundin; Joseph A Murray; David S Sanders; Marjorie M Walker; Fabiana Zingone; Carolina Ciacci Journal: Gut Date: 2012-02-16 Impact factor: 23.059