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[Latent celiac disease in subjects with serum anti-endomysial antibodies and normal intestinal biopsy].

Abstract

OBJECTIVES

Data on the follow-up of a group of subjects with serum antiendomysial antibodies (EMA) and normal mucosal architecture at the intestinal biopsy are reported. Clinical problems concerning possible evolution of potential celiac disease (CD) towards gluten-induced histological damage are discussed.

METHODS

Eleven patients belonging to high-risk groups for CD (5 with type-1 diabetes, 2 with familiarity for CD and 4 with symptoms suggesting CD) who had a normal intestinal biopsy, despite positive antiendomysial test, were followed-up. Antigliadin and antitransglutaminase antibodies (anti-tTG) and HLA genotyping were also assessed. According to clinical and serological data a second biopsy was performed in six of them.

RESULTS

At the time of the first normal biopsy, all patients were positive for EMA and 5/8 for anti-tTG. Five of 6 subjects genotyped were HLA-DQ2+ or DQ8+. Six patients were rebiopsed after 1 to 4 years. Three had mucosal atrophy, 1 had mild increase of intraepithelial lymphocytes and 2 were morphologically normal.

CONCLUSIONS

Subjects with antiendomysial antibodies and normal intestinal biopsy deserve clinical and serological follow-up to reduce the time of possible latency of CD. Although good predictors of progression of the disease are not still available, antiendomysial antibodies assessment and HLA genotyping may help to suggest individuals at higher risk to develop gluten-induced enteropathy. This study confirms that subjects with persistent signs of gluten sensitivity and normal biopsy should be re-examined.

Authors+Show Affiliations

,

Dipartimento Materno-Infantile e di Biologia e Genetica, Sezione di Pediatria, Università di Verona, Verona, Italy.

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Source

MeSH

Adolescent
Adult
Antibodies
Autoantibodies
Biopsy
Celiac Disease
Child
Child, Preschool
Female
Gliadin
Glutens
HLA-DQ Antigens
Humans
Immunoglobulin A
Intestines
Male
Muscle Fibers, Skeletal
Sensitivity and Specificity
Transglutaminases

Pub Type(s)

English Abstract
Journal Article

Language

ita

PubMed ID

12494536

Citation

Piccoli, A, et al. "[Latent Celiac Disease in Subjects With Serum Anti-endomysial Antibodies and Normal Intestinal Biopsy]." La Pediatria Medica E Chirurgica : Medical and Surgical Pediatrics, vol. 24, no. 5, 2002, pp. 358-62.
Piccoli A, Capelli P, Castagnini A, et al. [Latent celiac disease in subjects with serum anti-endomysial antibodies and normal intestinal biopsy]. Pediatr Med Chir. 2002;24(5):358-62.
Piccoli, A., Capelli, P., Castagnini, A., Cipolli, M., Contreas, G., Ulmi, D., ... Valletta, E. (2002). [Latent celiac disease in subjects with serum anti-endomysial antibodies and normal intestinal biopsy]. La Pediatria Medica E Chirurgica : Medical and Surgical Pediatrics, 24(5), pp. 358-62.
Piccoli A, et al. [Latent Celiac Disease in Subjects With Serum Anti-endomysial Antibodies and Normal Intestinal Biopsy]. Pediatr Med Chir. 2002;24(5):358-62. PubMed PMID: 12494536.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Latent celiac disease in subjects with serum anti-endomysial antibodies and normal intestinal biopsy]. AU - Piccoli,A, AU - Capelli,P, AU - Castagnini,A, AU - Cipolli,M, AU - Contreas,G, AU - Ulmi,D, AU - Zanoni,G, AU - Valletta,E, PY - 2002/12/24/pubmed PY - 2003/2/14/medline PY - 2002/12/24/entrez SP - 358 EP - 62 JF - La Pediatria medica e chirurgica : Medical and surgical pediatrics JO - Pediatr Med Chir VL - 24 IS - 5 N2 - OBJECTIVES: Data on the follow-up of a group of subjects with serum antiendomysial antibodies (EMA) and normal mucosal architecture at the intestinal biopsy are reported. Clinical problems concerning possible evolution of potential celiac disease (CD) towards gluten-induced histological damage are discussed. METHODS: Eleven patients belonging to high-risk groups for CD (5 with type-1 diabetes, 2 with familiarity for CD and 4 with symptoms suggesting CD) who had a normal intestinal biopsy, despite positive antiendomysial test, were followed-up. Antigliadin and antitransglutaminase antibodies (anti-tTG) and HLA genotyping were also assessed. According to clinical and serological data a second biopsy was performed in six of them. RESULTS: At the time of the first normal biopsy, all patients were positive for EMA and 5/8 for anti-tTG. Five of 6 subjects genotyped were HLA-DQ2+ or DQ8+. Six patients were rebiopsed after 1 to 4 years. Three had mucosal atrophy, 1 had mild increase of intraepithelial lymphocytes and 2 were morphologically normal. CONCLUSIONS: Subjects with antiendomysial antibodies and normal intestinal biopsy deserve clinical and serological follow-up to reduce the time of possible latency of CD. Although good predictors of progression of the disease are not still available, antiendomysial antibodies assessment and HLA genotyping may help to suggest individuals at higher risk to develop gluten-induced enteropathy. This study confirms that subjects with persistent signs of gluten sensitivity and normal biopsy should be re-examined. SN - 0391-5387 UR - https://www.unboundmedicine.com/medline/citation/12494536/[Latent_celiac_disease_in_subjects_with_serum_anti_endomysial_antibodies_and_normal_intestinal_biopsy]_ L2 - http://www.diseaseinfosearch.org/result/1186 DB - PRIME DP - Unbound Medicine ER -