scholarly journals Testing for Antireticulin Antibodies in Patients with Celiac Disease Is Obsolete: a Review of Recommendations for Serologic Screening and the Literature

2013 ◽  
Vol 20 (4) ◽  
pp. 447-451 ◽  
Author(s):  
Sarada L. Nandiwada ◽  
Anne E. Tebo
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Clinical Manifestations ◽  
Autoimmune Disorder ◽  
Diagnostic Use ◽  
Gliadin Peptide ◽  
Gluten Sensitive Enteropathy ◽  
Serologic Screening ◽  
Related Proteins ◽  
Hla Dq2

ABSTRACTCeliac disease (CD) is an autoimmune disorder that occurs in genetically susceptible individuals of all ages and is triggered by immune response to gluten and related proteins. The disease is characterized by the presence of HLA-DQ2 and/or -DQ8 haplotypes, diverse clinical manifestations, gluten-sensitive enteropathy, and production of several autoantibodies of which endomysial, tissue transglutaminase, and deamidated gliadin peptide antibodies are considered specific. Although antireticulin antibodies (ARA) have historically been used in the evaluation of CD, these assays lack optimal sensitivities and specificities for routine diagnostic use. This minireview highlights the advances in CD-specific serologic testing and the rationale for eliminating ARA from CD evaluation consistent with recommendations for diagnosis.

scholarly journals Spontaneous jejunoileal perforation as a manifestation of celiac disease—a rare entity: a case report

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Alex Paul Guachilema Ribadeneira ◽  
Naysi Cristina Zambrano Martinez ◽  
Silvana Alexandra Valencia Valverde ◽  
Raúl Ernesto Villacis Peñaherrera ◽  
Fabian Medardo Romero Chacón ◽  
...  
Keyword(s):  
Small Intestine ◽  
Celiac Disease ◽  
Clinical Manifestations ◽  
Human Leukocyte ◽  
Rare Condition ◽  
Autoimmune Response ◽  
Classical Type ◽  
High Morbidity ◽  
Gluten Sensitive Enteropathy ◽  
Hla Dq2

Abstract Celiac disease or gluten-sensitive enteropathy is characterized by an autoimmune response in the small intestine triggered by the ingestion of gluten in the diet. It has a prevalence of 0.62% worldwide with considerable variation in incidence among countries. The clinical manifestations of celiac disease differ according to type: the classical type presents with intestinal symptoms, the non-classical type with intestinal or extraintestinal symptoms and the silent type is asymptomatic. Human leukocyte antigens (HLA)-DQ2 (DQA1_05/DQB1_02) are expressed in >90% of patients with celiac disease, and the presence of HLA-DQ2 or HLA-DQ8 (DQA1_ 0301/DQB1_0302) is necessary for its development. One complication of this disease is ulcerative jejunoileitis, a rare condition characterized by chronic idiopathic ulceration affecting the small intestine that can cause intestinal perforation resulting in high morbidity.

scholarly journals Celiac Disease Prevalence in Patients with Chronic Noninflammatory Diarrhea in 2017

2021 ◽  
Author(s):  
Mahmud Baghbanian ◽  
Zahra Asadollahi
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Autoimmune Disorder ◽  
High Serum ◽  
P Value ◽  
Cross Sectional ◽  
Efficient Treatment ◽  
Inflammatory Diarrhea

Introduction: Celiac disease is an autoimmune disorder. Eating gluten, which is part of the cereals, can lead to intestinal mucosal injury and diarrhea. Although celiac disease is more common today with non-digestive symptoms, we sometimes encounter cases of chronic non-inflammatory diarrhea, which is one of the clinical manifestations of celiac disease. This study was performed to evaluate the prevalence of celiac disease in patients with chronic non-inflammatory diarrhea. Because diarrhea in celiac disease has distinct and efficient treatment we decided to do this study to evaluate the prevalence of celiac disease in patients with chronic non-inflammatory diarrhea. Methods: This was a descriptive cross sectional study on 200 patients with chronic non-inflammatory diarrhea in Yazd in 2017. Stool exam and tissue transglutaminase Antibody (TTG Ab) was done for the patients; upper endoscopy and duodenum biopsy was done for the patients with high serum TTG Ab. Findings analyzed in SPSS.ver.17 statistical software. Chi-Square, t-test and Fisher Exact tests were used for statistical analysis. P-value less than 0.05 was considered significant. Results: Two hundred patients, including 93 (46.5%) men and 107 women (53.5%) participated in this study. The average age was 34.32 ± 17.84 years. Among these cases, 31 patients (15.5%) had celiac disease.  Among cases of celiac (16.1%), 15 (16.1%) were male and 16 (15%) were female. The relative frequency of celiac disease was the same in both sexes and in all age groups. Conclusion: Significant portion of patients (15.5%) with chronic non-inflammatory diarrhea has celiac disease.

scholarly journals The Prevalence of Celiac Disease-Specific Auto-Antibodies in Type 1 Diabetes in a Moroccan Population

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Ider Oujamaa ◽  
Majda Sebbani ◽  
Lahcen Elmoumou ◽  
Aïcha Bourrahouate ◽  
Rabiy El Qadiry ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Iga Deficiency ◽  
Cross Sectional Study ◽  
Biological Data ◽  
Cross Sectional ◽  
Systematic Screening ◽  
Lower Height ◽  
Hla Dq2

Objective. We aimed to determine the prevalence of specific auto-antibodies to celiac disease (CD) in Moroccan type 1 diabetic (T1D) patients and compare the clinical and biological characteristics of seropositive and seronegative cases. Patients and Methods. A cross-sectional study was carried out on 276 T1D patients including 109 adults and 167 pediatric cases. The screening for CD was performed by an Elisa IgA anti-tissue transglutaminase antibody (tTGA) testing, combined with IgA quantification by nephelometry. Positive-IgA-tTGA cases were secondly tested for anti-endomysial antibodies (EMA) using an immunofluorescence technique, and the IgA deficiency cases were screened for IgG-tTGA. Patients with low positive tTGA titers underwent HLA-DQ2/DQ8 typing. Sociodemographic and clinical data of the patients were collected using a hetero-administered questionnaire. The comparison of clinical and biological data between seropositive and seronegative diabetics was done using independent T, Mann–Whitney U, chi-squared, and Fisher tests, which were considered significant if p value <0.05. Results. The prevalence of CD-specific auto-antibodies was estimated to be 9.1% (IC = 95%), with 25 positive cases in tTGA and EMA testing. Eight cases displayed low titers of IgA-tTGA, among which 4 were positive for HLA-DQ2, 1 for HLA-DQ8, and 1 for both DQ2 and DQ8. The other 2 cases had a biopsy-proven CD. Compared to seronegative patients, seropositive cases had a higher percentage of associated autoimmune disorders (16% vs. 2.4%, p=0.008), with a significant lower height Z-scores (median: −0.90 (−3.93 to 0.95) vs. −0.51 (−4.54 to 2.18), p=0.029) and a higher HbA1c level (median: 11.30% (7.31 to 16.00) vs. 9.30% (4.40 to17.31), p=0.022). Conclusion. The current study gave evidence of a high prevalence of CD specific auto-antibodies in T1D population. The co-existence of these two conditions was associated with a poor glycemic control, a lower height, and other autoimmune diseases. These findings may suggest the necessity of a systematic screening of CD in T1D patients.

scholarly journals THE USEFULNESS OF DEAMIDATED GLIADIN PEPTIDE IN SCREENING PEDIATRIC PATIENTS FOR CELIAC DISEASE

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e14-e14
Author(s):  
Michelle Gould ◽  
Herbert Brill ◽  
Margaret Marcon ◽  
Catharine Walsh
Keyword(s):  
Celiac Disease ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Tissue Transglutaminase ◽  
Paediatric Population ◽  
Iga Deficiency ◽  
Additional Patient ◽  
Serologic Marker ◽  
Paediatric Patients ◽  
Gliadin Peptide

Abstract BACKGROUND Celiac disease (CD) is an autoimmune enteropathy triggered by gliadin. The gold standard for diagnosis is small bowel biopsy. Screening with serologic markers to identify endoscopic candidates is commonly completed by paediatricians. The most common serologic marker used for screening is IgA anti-Tissue Transglutaminase (TTG) antibodies. Antibodies to deamidated gliadin peptide (DGP) is a newer assay with studies demonstrating a diagnostic performance similar to anti-TTG. In Canada, this assay has been added to many laboratory’s celiac screening panels. There is little evidence however regarding the usefulness of an isolated positive anti-DGP result in paediatric patients and no study has systematically assessed the presence of biopsy proven CD in solely anti-DGP positive paediatric patients. OBJECTIVES We sought to determine the positive predictive value of anti-DGP for biopsy proven CD in paediatric patients with negative TTG IgA testing. DESIGN/METHODS A multi-center retrospective review of children referred to three centers in Ontario, Canada between January 2015 and December 2016 who had isolated anti-IgG DGP positive CD serology was completed. To be included, patients required serology positive for DGP IgG and negative for all other celiac serologic tests, as well as a duodenal biopsy while on a gluten-containing diet. The positive predictive value of isolated anti-DGP was calculated. RESULTS A total of 83 patients were identified with anti-DGP positive, anti-TTG negative serology. Of these, 40 patients underwent endoscopy. Only 1 patient had findings consistent with CD on biopsy (Marsh 3B histology), yielding a positive predictive value of 2.5%. This patient was IgA deficient. Amongst the cohort of IgA sufficient patients (N=25), the positive predictive value of anti-DGP serology was 0%. One additional patient who was IgA sufficient had findings in keeping with Marsh 2 histology, but repeat TTG and DGP testing was negative. Five patients were found to be IgA deficient at the time of serologic testing, 25 were IgA sufficient and 10 did not have a measured IgA. CONCLUSION Isolated positive DGP IgG serology has a poor positive predictive value for CD, especially in IgA sufficient individuals. For this reason, DGP IgG testing should not be completed as part of the initial screening for celiac disease in the paediatric population unless a compelling reason, such as IgA deficiency or age under 2 years, is present, in order to prevent unnecessary invasive follow-up testing and costs to patients and the health care system.

scholarly journals Prevalence of celiac disease among first degree relatives of Brazilian celiac patients

2008 ◽  
Vol 45 (1) ◽  
pp. 69-72 ◽  
Author(s):  
Patrícia Lopes de Almeida ◽  
Lenora Gandolfi ◽  
Inês Cristina Modelli ◽  
Rita de Cássia Martins ◽  
Rodrigo Coutinho de Almeida ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Antibody Test ◽  
Autoimmune Disorder ◽  
University Hospital ◽  
Serological Tests ◽  
Intestinal Lesion ◽  
Serological Screening ◽  
First Degree Relatives ◽  
Small Intestinal

BACKGROUND: Several studies have shown that celiac disease, an autoimmune disorder that occurs in genetically susceptible individuals, is highly prevalent among relatives of celiac patients. AIM: To determine the prevalence of celiac disease in a group of first degree relatives of Brazilian celiac patients. METHODS: First degree relatives of celiac patients attending the Brasilia University Hospital Pediatric Gastroenterology Outpatient Clinic or the Celiac Disease Investigation Center, Brasília, DF, Brazil, between March 2001 and November 2004 were invited to undergo serological screening for celiac disease applying the IgA anti-endomysium antibody test (IgA-EMA). All positive IgA-EMA sera underwent a second screening using the IgA anti-tissue transglutaminase antibodies test. Duodenal or small intestinal biopsies were performed in all subjects positive to serological testing. Biopsy samples were classified as type (O) normal, (I) infiltrative, (II) infiltrative hyperplastic, (III) flat destructive, and (IV) atrophic hypoplastic. The final diagnosis was ascertained in subjects showing positive serological tests and a grade I to III small intestinal lesion. RESULTS: Nine new cases of celiac disease were found among the 188 first degree relatives tested (4.8%). CONCLUSION: The present study confirms the high prevalence of celiac disease among first degree celiac patients’ relatives and reinforces the need of extensive diagnostic screening in this specific group.

An Attempt of Specific Desensitising Treatment with Gliadin in Celiac Disease

2005 ◽  
Vol 18 (4) ◽  
pp. 709-714 ◽  
Author(s):  
G. Patriarca ◽  
N. Pogna ◽  
G. Cammarota ◽  
D. Schiavino ◽  
C. Lombardo ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Clinical Manifestations ◽  
Current Treatment ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Dietary Regimen ◽  
New Approach ◽  
Tissue Transglutaminase Antibodies

Gluten-free diet is the current treatment of celiac disease. We decided to verify the occurrence of histological and serological modification and/or clinical manifestations during a gradual and progressive introduction of gliadin in the diet and if it may induce a tolerance to food, as it occurs in allergic patients. We studied the case of a celiac woman with complete clinical and histological remittance after 10 years of gluten free diet. She took increasing daily doses of gliadin, reaching the final dose of 9 g of gliadin (15 g of gluten) in 6 months. Then she started a free dietary regimen. During the 15-month follow-up period esophago-gastro-duodenoscopy showed normal Kerckring folds and villi. Anti-gliadin, anti-endomysium and anti-tissue-transglutaminase antibodies, as well as the haematological and biochemical parameters remained normal. Our results represent a new approach in the research concerning celiac disease, and could provide a future line of study for its management.

scholarly journals Rare Neurological Manifestation of Celiac Disease

2015 ◽  
Vol 9 (2) ◽  
pp. 200-205 ◽  
Author(s):  
Uzma Rani ◽  
Aamer Imdad ◽  
Mirza Beg
Keyword(s):  
Celiac Disease ◽  
Psychiatric Symptoms ◽  
Tissue Transglutaminase ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Pseudotumor Cerebri ◽  
Neurological Manifestation ◽  
Upper Gastrointestinal Endoscopy ◽  
Blurred Vision ◽  
And Behavior

Celiac disease (CD) is an immune-mediated disease characterized by permanent gastrointestinal tract sensitivity to gluten in genetically predisposed individuals. It has varied clinical manifestations, ranging from gastrointestinal to extraintestinal, including neurological, skin, reproductive and psychiatric symptoms, which makes its diagnosis difficult and challenging. Known neurological manifestations of CD include epilepsy with or without occipital calcification, attention deficit hyperactivity disorder and ataxia, headache, neuropathies and behavior disorders. We present the case of a 14-year-old female with headaches and blurred vision for 1 year; she was noted to have papilledema on ophthalmic examination with increased cerebrospinal fluid opening pressure on lumber puncture and was diagnosed as a case of pseudotumor cerebri (PTC). Meanwhile her workup for chronic constipation revealed elevated tissue transglutaminase IgA and antiendomysial IgA antibodies. Upper gastrointestinal endoscopy with duodenal biopsy confirmed the diagnosis of CD. The patient was started on a gluten-free diet, leading to resolution of not only gastrointestinal symptoms but also to almost complete resolution of symptoms of PTC. This report describes the correlation of CD and PTC as its neurological manifestation.

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