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Gluten sensitivity in patients with primary biliary cirrhosis.
Am J Gastroenterol 1998; 93(3):404-8AJ

Abstract

OBJECTIVE

Whereas celiac disease and primary biliary cirrhosis have been reported to coexist in the same patient, the frequency of this relationship has not been clarified. Nowadays, the concept of celiac disease has been extended from that of a severe enteropathy to a broader concept of gluten-driven intestinal immunological response. In this study we assessed features of gluten sensitivity in a cohort of patients with primary biliary cirrhosis.

METHODS

Ten patients with primary biliary cirrhosis were evaluated a mean of 2 yr after diagnosis. The following features of gluten sensitivity were assessed: serum antigliadin and endomysial antibodies, small bowel histology (degree of atrophy and quantitative histological parameters), the presence of the typical celiac HLA genotype (DQ2), and intraepithelial lymphocyte response in the rectal mucosa after local gluten instillation (rectal gluten challenge).

RESULTS

Overall, three patients presented evidence of gluten sensitivity. All three had abnormal titers of antigliadin antibody type IgA and one was positive for endomysial antibody. Two patients had partial villous atrophy. The rectal gluten challenge showed a celiac-like response, evidenced by an increase in intraepithelial lymphocyte infiltration after gluten exposure, in the three patients. The characteristic celiac HLA genotypes (DQA1 0501 and DQB1 0201) were identified in three patients. One of them also exhibited other features of gluten sensitivity. However, despite evidence of gluten intolerance, patients had minimal or no symptoms characteristic of celiac disease.

CONCLUSION

We detected features of gluten sensitivity in a high proportion of patients with primary biliary cirrhosis. Further studies should be performed to elucidate the clinical significance of this association.

Authors+Show Affiliations

Clinical Department, Hospital de Gastroenterología Dr Carlos Bonorino Udaondo, Universidad del Salvador, 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 availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9580141

Citation

Niveloni, S, et al. "Gluten Sensitivity in Patients With Primary Biliary Cirrhosis." The American Journal of Gastroenterology, vol. 93, no. 3, 1998, pp. 404-8.
Niveloni S, Dezi R, Pedreira S, et al. Gluten sensitivity in patients with primary biliary cirrhosis. Am J Gastroenterol. 1998;93(3):404-8.
Niveloni, S., Dezi, R., Pedreira, S., Podestá, A., Cabanne, A., Vazquez, H., ... Bai, J. C. (1998). Gluten sensitivity in patients with primary biliary cirrhosis. The American Journal of Gastroenterology, 93(3), pp. 404-8.
Niveloni S, et al. Gluten Sensitivity in Patients With Primary Biliary Cirrhosis. Am J Gastroenterol. 1998;93(3):404-8. PubMed PMID: 9580141.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gluten sensitivity in patients with primary biliary cirrhosis. AU - Niveloni,S, AU - Dezi,R, AU - Pedreira,S, AU - Podestá,A, AU - Cabanne,A, AU - Vazquez,H, AU - Sugai,E, AU - Smecuol,E, AU - Doldan,I, AU - Valero,J, AU - Kogan,Z, AU - Boerr,L, AU - Mauriño,E, AU - Terg,R, AU - Bai,J C, PY - 1998/5/15/pubmed PY - 1998/5/15/medline PY - 1998/5/15/entrez SP - 404 EP - 8 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 93 IS - 3 N2 - OBJECTIVE: Whereas celiac disease and primary biliary cirrhosis have been reported to coexist in the same patient, the frequency of this relationship has not been clarified. Nowadays, the concept of celiac disease has been extended from that of a severe enteropathy to a broader concept of gluten-driven intestinal immunological response. In this study we assessed features of gluten sensitivity in a cohort of patients with primary biliary cirrhosis. METHODS: Ten patients with primary biliary cirrhosis were evaluated a mean of 2 yr after diagnosis. The following features of gluten sensitivity were assessed: serum antigliadin and endomysial antibodies, small bowel histology (degree of atrophy and quantitative histological parameters), the presence of the typical celiac HLA genotype (DQ2), and intraepithelial lymphocyte response in the rectal mucosa after local gluten instillation (rectal gluten challenge). RESULTS: Overall, three patients presented evidence of gluten sensitivity. All three had abnormal titers of antigliadin antibody type IgA and one was positive for endomysial antibody. Two patients had partial villous atrophy. The rectal gluten challenge showed a celiac-like response, evidenced by an increase in intraepithelial lymphocyte infiltration after gluten exposure, in the three patients. The characteristic celiac HLA genotypes (DQA1 0501 and DQB1 0201) were identified in three patients. One of them also exhibited other features of gluten sensitivity. However, despite evidence of gluten intolerance, patients had minimal or no symptoms characteristic of celiac disease. CONCLUSION: We detected features of gluten sensitivity in a high proportion of patients with primary biliary cirrhosis. Further studies should be performed to elucidate the clinical significance of this association. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/9580141/Gluten_sensitivity_in_patients_with_primary_biliary_cirrhosis_ L2 - http://Insights.ovid.com/pubmed?pmid=9580141 DB - PRIME DP - Unbound Medicine ER -