E Arranz1, A Ferguson. 1. Gastrointestinal Unit, University of Edinburgh, Scotland.
Abstract
BACKGROUND: Patients with celiac disease have immunoglobulin (Ig) M antibodies and IgA antigliadin antibody in gut secretions; this pattern of intestinal immunity may be a marker of latent celiac disease. Its frequency in patients referred for jejunal biopsy has been examined. METHODS: Serum IgG and IgA antigliadin antibody, jejunal fluid IgA and IgM antibodies to gliadin, ovalbumin and beta lactoglobulin, and jejunal fluid IgA and IgM concentrations were measured by enzyme-linked immunosorbent assay. RESULTS: Seventeen of 19 celiac patients on normal diet and 16 of 23 on gluten-free diet had the celiaclike antibody pattern, as did 41 of 217 other patients. Jejunal biopsy histology had been classified as normal in 38 of these, with minor abnormalities in 3; however, intraepithelial lymphocyte (IEL) counts were high in 13 cases. Trial of a gluten-free diet produced clinical improvement in 6 of 7 antibody-positive patients. After extra dietary gluten, one developed subtotal villous atrophy. CONCLUSIONS: The celiaclike intestinal antibody pattern and a high IEL count may be markers of latent gluten-sensitive enteropathy; some of these patients are clinically gluten sensitive in the absence of enteropathy.
BACKGROUND:Patients with celiac disease have immunoglobulin (Ig) M antibodies and IgA antigliadin antibody in gut secretions; this pattern of intestinal immunity may be a marker of latent celiac disease. Its frequency in patients referred for jejunal biopsy has been examined. METHODS: Serum IgG and IgA antigliadin antibody, jejunal fluid IgA and IgM antibodies to gliadin, ovalbumin and beta lactoglobulin, and jejunal fluid IgA and IgM concentrations were measured by enzyme-linked immunosorbent assay. RESULTS: Seventeen of 19 celiac patients on normal diet and 16 of 23 on gluten-free diet had the celiaclike antibody pattern, as did 41 of 217 other patients. Jejunal biopsy histology had been classified as normal in 38 of these, with minor abnormalities in 3; however, intraepithelial lymphocyte (IEL) counts were high in 13 cases. Trial of a gluten-free diet produced clinical improvement in 6 of 7 antibody-positive patients. After extra dietary gluten, one developed subtotal villous atrophy. CONCLUSIONS: The celiaclike intestinal antibody pattern and a high IEL count may be markers of latent gluten-sensitive enteropathy; some of these patients are clinically gluten sensitive in the absence of enteropathy.
Authors: M Bonamico; G Ballati; P Mariani; M Latini; P Triglione; I Rana; E Porro; M A Mesturino; S Criscione Journal: Eur J Epidemiol Date: 1997-01 Impact factor: 8.082
Authors: Jörg Schedel; Felix Rockmann; Tim Bongartz; Matthias Woenckhaus; Jürgen Schölmerich; Frank Kullmann Journal: Int J Colorectal Dis Date: 2004-12-01 Impact factor: 2.571
Authors: M ten Dam; Y Van De Wal; M L Mearin; Y Kooy; S Peña; J W Drijfhout; F Koning; M Van Tol Journal: Clin Exp Immunol Date: 1998-11 Impact factor: 4.330