Gluten-sensitive disease with mild enteropathy

109Citations
Citations of this article
38Readers
Mendeley users who have this article in their library.

Abstract

Background and Aims: Celiac disease is a permanent gluten intolerance strongly associated with HLA class II antigens and possibly showing milder changes of mucosal architecture. Ten patients with symptoms suggesting celiac disease and serum antiendomysium antibodies with normal mucosal architecture were studied. Methods: Immunohistochemical detection of mucosal immune activation and HLA typings were performed. Results: Mucosal immune activation, with normal mucosal architecture and normal τ/δ+ intraepithelial lymphocytes counts, was found on a gluten-containing diet. In 3 of 6 patients, multiple biopsy specimens showed one sample with severe villous atrophy. Clinical and immunomorphologic features were strictly gluten dependent. The mucosal immune activation was elicited in vitro by gliadin. Only 4 patients had the typical HLA typing of celiac disease. Conclusions: Gluten-sensitive celiac-like symptoms may occur in patients with serum antiendomysium antibodies, apparently normal intestinal mucosa, and HLA typing not commonly associated with celiac disease. These patients should undergo multiple biopsies, and signs of immunologic activation should be sought accurately; in the presence of mucosal immune activation, a trial with a gluten-free diet should be encouraged to detect gluten dependency. In vitro immunologic response of small intestinal mucosa to gliadin may support the diagnosis of gluten-sensitive enteropathy.

Cited by Powered by Scopus

Current approaches to diagnosis and treatment of celiac disease: An evolving spectrum

1120Citations
N/AReaders
Get full text

American Gastroenterological Association (AGA) Institute Technical Review on the Diagnosis and Management of Celiac Disease

642Citations
N/AReaders
Get full text

Coeliac disease

569Citations
N/AReaders
Get full text

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Cite

CITATION STYLE

APA

Picarelli, A., Maiuri, L., Mazzilli, M. C., Coletta, S., Ferrante, P., Di Giovambattista, F., … Auricchio, S. (1996). Gluten-sensitive disease with mild enteropathy. Gastroenterology, 111(3), 608–616. https://doi.org/10.1053/gast.1996.v111.pm8780564

Readers' Seniority

Tooltip

PhD / Post grad / Masters / Doc 17

77%

Professor / Associate Prof. 3

14%

Researcher 2

9%

Readers' Discipline

Tooltip

Medicine and Dentistry 10

43%

Engineering 7

30%

Agricultural and Biological Sciences 3

13%

Biochemistry, Genetics and Molecular Bi... 3

13%

Article Metrics

Tooltip
Social Media
Shares, Likes & Comments: 1

Save time finding and organizing research with Mendeley

Sign up for free