OBJECTIVE: To evaluate the frequency and the natural history of potential (serology positive/Marsh 0-1 histology) celiac disease (CD) in children with a family risk of CD and factors associated with potential instead of overt (serology positive/Marsh 2-3 histology) CD expression. STUDY DESIGN: Two-year follow-up study of 96 children (57 females; mean age: 29 ± 12 months) prospectively investigated from birth with: (1) a CD-affected first-degree relative; (2) positivity of serum IgA anti-tissue transglutaminase (tTG) or IgG antigliadin and IgA deficiency; and (3) the results of small intestinal biopsy. Children with potential CD were advised to remain on a gluten containing diet, repeat the celiac antibodies every 6 months, and to have an intestinal biopsy performed in case of persistently high anti-tTG level. Factors discriminating between potential and overt CD were analyzed by decision tree analysis based on the C4.5 algorithm. RESULTS: Twenty-four children had potential and 72 overt CD. The stronger predictors of potential CD were lack of symptoms, anti-tTG level lower than 11-fold the upper normal limit, age lower than 24 months, and breastfeeding longer than 8 months. Eighteen out of 21 (86%) patients with potential CD continuing a gluten-containing diet became antibody negative, 1/21 (5%) developed overt CD, and 2/21 (9%) had fluctuating antibodies levels after 2 years. CONCLUSIONS: The prevalence of potential CD and the percentage of short-term loss of CD-related-antibodies are high in infants at-family-risk for CD. In symptomless children with a positive celiac serology, the decision of performing an intestinal biopsy should be preceded by a period of repeated serological testing.
OBJECTIVE: To evaluate the frequency and the natural history of potential (serology positive/Marsh 0-1 histology) celiac disease (CD) in children with a family risk of CD and factors associated with potential instead of overt (serology positive/Marsh 2-3 histology) CD expression. STUDY DESIGN: Two-year follow-up study of 96 children (57 females; mean age: 29 ± 12 months) prospectively investigated from birth with: (1) a CD-affected first-degree relative; (2) positivity of serum IgA anti-tissue transglutaminase (tTG) or IgG antigliadin and IgA deficiency; and (3) the results of small intestinal biopsy. Children with potential CD were advised to remain on a gluten containing diet, repeat the celiac antibodies every 6 months, and to have an intestinal biopsy performed in case of persistently high anti-tTG level. Factors discriminating between potential and overt CD were analyzed by decision tree analysis based on the C4.5 algorithm. RESULTS: Twenty-four children had potential and 72 overt CD. The stronger predictors of potential CD were lack of symptoms, anti-tTG level lower than 11-fold the upper normal limit, age lower than 24 months, and breastfeeding longer than 8 months. Eighteen out of 21 (86%) patients with potential CD continuing a gluten-containing diet became antibody negative, 1/21 (5%) developed overt CD, and 2/21 (9%) had fluctuating antibodies levels after 2 years. CONCLUSIONS: The prevalence of potential CD and the percentage of short-term loss of CD-related-antibodies are high in infants at-family-risk for CD. In symptomless children with a positive celiac serology, the decision of performing an intestinal biopsy should be preceded by a period of repeated serological testing.
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
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Authors: G Serena; S Yan; S Camhi; S Patel; R S Lima; A Sapone; M M Leonard; R Mukherjee; B J Nath; K M Lammers; A Fasano Journal: Clin Exp Immunol Date: 2017-01-12 Impact factor: 4.330
Authors: Romain Bouziat; Reinhard Hinterleitner; Judy J Brown; Jennifer E Stencel-Baerenwald; Mine Ikizler; Toufic Mayassi; Marlies Meisel; Sangman M Kim; Valentina Discepolo; Andrea J Pruijssers; Jordan D Ernest; Jason A Iskarpatyoti; Léa M M Costes; Ian Lawrence; Brad A Palanski; Mukund Varma; Matthew A Zurenski; Solomiia Khomandiak; Nicole McAllister; Pavithra Aravamudhan; Karl W Boehme; Fengling Hu; Janneke N Samsom; Hans-Christian Reinecker; Sonia S Kupfer; Stefano Guandalini; Carol E Semrad; Valérie Abadie; Chaitan Khosla; Luis B Barreiro; Ramnik J Xavier; Aylwin Ng; Terence S Dermody; Bana Jabri Journal: Science Date: 2017-04-07 Impact factor: 47.728
Authors: Simona Gatti; Matilde Rossi; Simona Alfonsi; Alessandra Mandolesi; Giovanni Cobellis; Carlo Catassi Journal: Front Med (Lausanne) Date: 2014-05-02