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Celiac disease serology in dermatitis herpetiformis. Which is the best option for detecting gluten sensitivity?
Acta Gastroenterol Latinoam 2006; 36(4):197-201AG

Abstract

BACKGROUND

Dermatitis herpetiformis (DH), a well-established gluten-sensitive skin disorder presenting variable degrees of enteropathy, constitutes a very useful model in order to assess the utility of the celiac disease (CD)-related serology in patients with mild intestinal damage.

OBJECTIVE

Our aim was to explore comparatively the performance of a panel of CD-related serologic tests in patients with DH.

METHODS

We assessed a series of 18 consecutive patients with skin biopsy proven DH presenting the overall spectrum of intestinal damage ranging from normal mucosa (n = 6) to total villous atrophy (TVA) (n = 6) through partial villous atrophy (PVA) (n = 6). Sera were obtained from all patients while consuming a gluten containing diet. Serologic tests were antiendomysial, anti-tissue transglutaminase and antigliadin antibodies, and newly developed tests detecting both antibody isotypes (IgA and IgG) against deamidated synthetic gliadin-derived peptides (a-GDP).

RESULTS

Serologic tests had a variable behaviour depending on the degree of enteropathy. While the majority of tests detected patients with TVA, only 50% of those with normal histology had positive assays. Patients with PVA had discordant results. Classical CD-specific tests were positive in only some patients with mild damage while all of them were identifed by a single assay detecting both isotypes of a-GDR CONCLUSION: The detection of a-GDP antibodies was the most reliable tool in order to identify gluten sensitivity in DH patients presenting a wide range of intestinal damage. Further studies should explore if these findings can be extrapolated to patients with CD having mild enteropathy.

Authors+Show Affiliations

Small Bowel Section, Department of Medicine, Hospital de Gastroenterología "Dr. Carlos Bonorino Udaondo", Buenos Aires, Argentina.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17225447

Citation

Sugai, Emilia, et al. "Celiac Disease Serology in Dermatitis Herpetiformis. Which Is the Best Option for Detecting Gluten Sensitivity?" Acta Gastroenterologica Latinoamericana, vol. 36, no. 4, 2006, pp. 197-201.
Sugai E, Smecuol E, Niveloni S, et al. Celiac disease serology in dermatitis herpetiformis. Which is the best option for detecting gluten sensitivity? Acta Gastroenterol Latinoam. 2006;36(4):197-201.
Sugai, E., Smecuol, E., Niveloni, S., Vázquez, H., Label, M., Mazure, R., ... Bai, J. C. (2006). Celiac disease serology in dermatitis herpetiformis. Which is the best option for detecting gluten sensitivity? Acta Gastroenterologica Latinoamericana, 36(4), pp. 197-201.
Sugai E, et al. Celiac Disease Serology in Dermatitis Herpetiformis. Which Is the Best Option for Detecting Gluten Sensitivity. Acta Gastroenterol Latinoam. 2006;36(4):197-201. PubMed PMID: 17225447.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Celiac disease serology in dermatitis herpetiformis. Which is the best option for detecting gluten sensitivity? AU - Sugai,Emilia, AU - Smecuol,Edgardo, AU - Niveloni,Sonia, AU - Vázquez,Horacio, AU - Label,Marcelo, AU - Mazure,Roberto, AU - Czech,Andrea, AU - Kogan,Zulema, AU - Mauriño,Eduardo, AU - Bai,Julio C, PY - 2007/1/18/pubmed PY - 2007/10/30/medline PY - 2007/1/18/entrez SP - 197 EP - 201 JF - Acta gastroenterologica Latinoamericana JO - Acta Gastroenterol. Latinoam. VL - 36 IS - 4 N2 - BACKGROUND: Dermatitis herpetiformis (DH), a well-established gluten-sensitive skin disorder presenting variable degrees of enteropathy, constitutes a very useful model in order to assess the utility of the celiac disease (CD)-related serology in patients with mild intestinal damage. OBJECTIVE: Our aim was to explore comparatively the performance of a panel of CD-related serologic tests in patients with DH. METHODS: We assessed a series of 18 consecutive patients with skin biopsy proven DH presenting the overall spectrum of intestinal damage ranging from normal mucosa (n = 6) to total villous atrophy (TVA) (n = 6) through partial villous atrophy (PVA) (n = 6). Sera were obtained from all patients while consuming a gluten containing diet. Serologic tests were antiendomysial, anti-tissue transglutaminase and antigliadin antibodies, and newly developed tests detecting both antibody isotypes (IgA and IgG) against deamidated synthetic gliadin-derived peptides (a-GDP). RESULTS: Serologic tests had a variable behaviour depending on the degree of enteropathy. While the majority of tests detected patients with TVA, only 50% of those with normal histology had positive assays. Patients with PVA had discordant results. Classical CD-specific tests were positive in only some patients with mild damage while all of them were identifed by a single assay detecting both isotypes of a-GDR CONCLUSION: The detection of a-GDP antibodies was the most reliable tool in order to identify gluten sensitivity in DH patients presenting a wide range of intestinal damage. Further studies should explore if these findings can be extrapolated to patients with CD having mild enteropathy. SN - 0300-9033 UR - https://www.unboundmedicine.com/medline/citation/17225447/Celiac_disease_serology_in_dermatitis_herpetiformis__Which_is_the_best_option_for_detecting_gluten_sensitivity L2 - http://www.diseaseinfosearch.org/result/2342 DB - PRIME DP - Unbound Medicine ER -