Tags

Type your tag names separated by a space and hit enter

Is a gluten-free diet necessary in Marsh I intestinal lesions in patients with HLADQ2, DQ8 genotype and without gastrointestinal symptoms?
Curr Opin Clin Nutr Metab Care. 2012 Sep; 15(5):505-10.CO

Abstract

PURPOSE OF REVIEW

To describe whether a gluten-free diet (GFD) is indicated in Marsh I gluten-sensitive enteropathy where gastrointestinal symptoms are not present. Arguments are provided to prescribe a GFD to manage extraintestinal symptoms. By contrast, there are not enough reasons to prescribe a GFD to prevent long-term complications.

RECENT FINDINGS

Population-based and prospective observational studies have found that lymphocytic duodenosis may be due to not just gluten-sensitive enteropathy but also due to other aetiologic factors. Marsh I type lesions may be the cause of iron-deficiency anaemia of unknown aetiology which is reverted by a GFD. A similar effect seems to occur with bone mineralization and hypertransaminasemia. The beneficial influence of a GFD reducing lymphoma and coeliac disease-related mortality remains controversial.

SUMMARY

An appropriate differential diagnosis of the lymphocytic duodenosis is essential before a GFD is indicated. As a third of patients remained undiagnosed, in spite of genetic study and specific coeliac serology, flow cytometry and transglutaminase antibodies in duodenal tissue may be helpful in establishing gluten-sensitive enteropathy diagnosis. Future studies should assess whether lymphoma risk is reduced by a GFD in Marsh I patients. Also a more precise benefit in bone mineralization in this setting is needed.

Authors+Show Affiliations

Department of Gastroenterology. Hospital Universitari Mútua de Terrassa, Fundació per Recerca Mútua de Terrassa, Universitat de Barcelona, Terrassa, Catalonia, Spain. mestevecomas@telefonica.netNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

22878244

Citation

Esteve, Maria, et al. "Is a Gluten-free Diet Necessary in Marsh I Intestinal Lesions in Patients With HLADQ2, DQ8 Genotype and Without Gastrointestinal Symptoms?" Current Opinion in Clinical Nutrition and Metabolic Care, vol. 15, no. 5, 2012, pp. 505-10.
Esteve M, Carrasco A, Fernandēz-Bañares F. Is a gluten-free diet necessary in Marsh I intestinal lesions in patients with HLADQ2, DQ8 genotype and without gastrointestinal symptoms? Curr Opin Clin Nutr Metab Care. 2012;15(5):505-10.
Esteve, M., Carrasco, A., & Fernandēz-Bañares, F. (2012). Is a gluten-free diet necessary in Marsh I intestinal lesions in patients with HLADQ2, DQ8 genotype and without gastrointestinal symptoms? Current Opinion in Clinical Nutrition and Metabolic Care, 15(5), 505-10. https://doi.org/10.1097/MCO.0b013e3283566643
Esteve M, Carrasco A, Fernandēz-Bañares F. Is a Gluten-free Diet Necessary in Marsh I Intestinal Lesions in Patients With HLADQ2, DQ8 Genotype and Without Gastrointestinal Symptoms. Curr Opin Clin Nutr Metab Care. 2012;15(5):505-10. PubMed PMID: 22878244.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is a gluten-free diet necessary in Marsh I intestinal lesions in patients with HLADQ2, DQ8 genotype and without gastrointestinal symptoms? AU - Esteve,Maria, AU - Carrasco,Anna, AU - Fernandēz-Bañares,Fernando, PY - 2012/8/11/entrez PY - 2012/8/11/pubmed PY - 2012/12/10/medline SP - 505 EP - 10 JF - Current opinion in clinical nutrition and metabolic care JO - Curr Opin Clin Nutr Metab Care VL - 15 IS - 5 N2 - PURPOSE OF REVIEW: To describe whether a gluten-free diet (GFD) is indicated in Marsh I gluten-sensitive enteropathy where gastrointestinal symptoms are not present. Arguments are provided to prescribe a GFD to manage extraintestinal symptoms. By contrast, there are not enough reasons to prescribe a GFD to prevent long-term complications. RECENT FINDINGS: Population-based and prospective observational studies have found that lymphocytic duodenosis may be due to not just gluten-sensitive enteropathy but also due to other aetiologic factors. Marsh I type lesions may be the cause of iron-deficiency anaemia of unknown aetiology which is reverted by a GFD. A similar effect seems to occur with bone mineralization and hypertransaminasemia. The beneficial influence of a GFD reducing lymphoma and coeliac disease-related mortality remains controversial. SUMMARY: An appropriate differential diagnosis of the lymphocytic duodenosis is essential before a GFD is indicated. As a third of patients remained undiagnosed, in spite of genetic study and specific coeliac serology, flow cytometry and transglutaminase antibodies in duodenal tissue may be helpful in establishing gluten-sensitive enteropathy diagnosis. Future studies should assess whether lymphoma risk is reduced by a GFD in Marsh I patients. Also a more precise benefit in bone mineralization in this setting is needed. SN - 1473-6519 UR - https://www.unboundmedicine.com/medline/citation/22878244/Is_a_gluten_free_diet_necessary_in_Marsh_I_intestinal_lesions_in_patients_with_HLADQ2_DQ8_genotype_and_without_gastrointestinal_symptoms L2 - https://doi.org/10.1097/MCO.0b013e3283566643 DB - PRIME DP - Unbound Medicine ER -