Relation of Antigliadin Antibodies to Gluten-Sensitive Enteropathy

2020 ◽  
pp. 77-86
Author(s):  
Eeva Vainio ◽  
Markku Viander ◽  
Olavi Hällström ◽  
Timo Reunala
Keyword(s):  
Antigliadin Antibodies ◽  
Gluten Sensitive Enteropathy

Coeliac disease and the liver: spectrum of liver histology, serology and treatment response at a tertiary referral centre

2017 ◽  
Vol 71 (5) ◽  
pp. 412-419 ◽  
Author(s):  
Kaushik Majumdar ◽  
Puja Sakhuja ◽  
Amarender Singh Puri ◽  
Kavita Gaur ◽  
Aiman Haider ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Biopsy ◽  
Coeliac Disease ◽  
Liver Function Tests ◽  
Liver Histology ◽  
Tertiary Referral Centre ◽  
Antigliadin Antibodies ◽  
Gluten Sensitive Enteropathy ◽  
Liver Biopsies ◽  
Laboratory Investigations

BackgroundCoeliac disease (CD) is a gluten-sensitive enteropathy diagnosed on the basis of ESPGHAN criteria and clinical response to gluten-free diet (GFD). Histological abnormalities on liver biopsy have been noted in CD but have seldom been described.AimsTo assess the histological spectrum of ‘coeliac hepatitis’ and possibility of reversal of such features after a GFD.MethodsTwenty-five patients with concomitant CD and hepatic derangement were analysed for clinical profile, laboratory investigations and duodenal and liver biopsy. A histological comparison of pre- and post-GFD duodenal and liver biopsies was carried out, wherever possible.ResultsFifteen patients presenting with CD subsequently developed abnormal liver function tests; 10 patients presenting with liver disease were found to have tissue positive transglutaminase in 70% and antigliadin antibodies in 60%. Serological markers for autoimmune liver disease (AILD) were positive in eight patients. Liver histology ranged from mild reactive hepatitis, chronic hepatitis, steatosis to cirrhosis. Liver biopsies after a GFD were available in six cases, of which five showed a decrease in steatosis, portal and lobular inflammation and fibrosis score.ConclusionCoeliac hepatitis could be a distinct entity and the patients may present with either CD or secondary hepatic derangement. Evaluation for the presence of CD is recommended for patients presenting with AILD, unexplained transaminasaemia or anaemia. This is one of the very few studies demonstrating the continuum of liver histological changes in ‘coeliac hepatitis’. Trial of a GFD may result in clinicopathological improvement of ‘coeliac hepatitis’.

Natural Killer–like T-Cell Lymphoma of the Small Intestine With a Distinct Immunophenotype and Lack of Association With Gluten-Sensitive Enteropathy

2003 ◽  
Vol 127 (3) ◽  
pp. e142-e146 ◽  
Author(s):  
Constance M. Yuan ◽  
Steven Stein ◽  
John H. Glick ◽  
Mariusz A. Wasik
Keyword(s):  
Small Intestine ◽  
T Cell ◽  
Natural Killer ◽  
Chromosomal Abnormalities ◽  
Nk Cell ◽  
Cell Lymphoma ◽  
T Cell Lymphoma ◽  
Chain Gene ◽  
Antigliadin Antibodies ◽  
Gluten Sensitive Enteropathy

Abstract We report the case of a large natural killer (NK)–like T-cell lymphoma that involved the ileum and displayed a distinct immunophenotype and complex karyotype. The patient exhibited no evidence of gluten-sensitive enteropathy (celiac disease) or any other type of enteropathy as determined by clinical history, endoscopy, and serology for immunoglobulin A (IgA) antiendomysial and IgG antigliadin antibodies. Molecular studies demonstrated a clonal T-cell receptor γ chain gene rearrangement. Immunophenotype analysis showed expression of intestinal epithelium-homing receptor CD103, CD7, cytoplasmic CD3ɛ, CD56, and CD16 but no other T- or NK-cell markers. Cytogenetic analysis of the malignant cells revealed multiple chromosomal abnormalities indicative of a biologically advanced, high-grade lymphoma. A novel subset of normal intestinal intraepithelial lymphocytes, bearing a similar phenotype, has been described; moreover, this subset diminishes, rather than expands, in gluten-sensitive enteropathy. This case supports the notion that lymphomas involving the small intestine represent a heterogeneous group of lymphomas with diverse pathogenetic mechanisms.

Nutritional Management of Celiac Disease

2018 ◽  
Author(s):  
Ciarán P Kelly ◽  
Satya Kurada ◽  
Mariana Urquiaga
Keyword(s):  
Immune Response ◽  
Celiac Disease ◽  
Tight Junction ◽  
Villous Atrophy ◽  
Gastrointestinal Symptoms ◽  
Gluten Free Diet ◽  
Intestinal Biopsy ◽  
Nutritional Management ◽  
Gluten Free ◽  
Antigliadin Antibodies

Celiac disease (CD) is an autoimmune disorder characterized by an immune response to gluten peptides in wheat, barley, and rye. The diagnosis of celiac disease is confirmed by three important characteristics: consistent symptoms, positive celiac-specific serology, and small intestinal biopsy findings of inflammation, crypt hyperplasia, and villous atrophy. CD may present with overt gastrointestinal symptoms, including diarrhea (or constipation), weight loss, and abdominal bloating and discomfort, or covertly with micronutrient deficiencies such as iron deficiency with anemia. A gluten-free diet (GFD) remains the mainstay of treatment. The aim of this review is to highlight the pathogenesis of CD, concepts and challenges associated with a GFD, and nutritional management of CD applicable in clinical practice to internists, gastroenterologists, and dietitians. Patients should be referred to an expert celiac dietitian for education on adherence to a GFD to address gluten contamination in the diet, the psychosocial implications of following a GFD, and macro- and micronutrient disequilibria arising from celiac disease and the GFD. Several novel therapeutics are on the horizon in various stages of development, including glutenases, antigliadin antibodies, tight junction regulators, modulation of the immune response to gliadin, and efforts to engineer less toxic gluten-containing foodstuffs. This review contains 3 figures, 5 tables, and 61 references. Key words: celiac disease, genetic engineering, food engineering, gluten, glutenases, gluten-free diet, oats, IgY, nutrition, tight junction regulators, wheat

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