Background & Aims: Celiac disease is a permanent gluten intolerance strongly associated with HLA class II antigens and possibly showing milder changes of mucosal architecture, Ten patients with symptoms suggesting celiac disease and serum antiendomysium antibodies with normal mucosal architecture were studied. Methods: Immunohistochemical detection of mucosal immune activation and HLA typings were performed. Results, Mucosal immune activation, with normal mucosal architecture and normal gamma/delta(+) intraepithelial lymphocytes counts, was found on a gluten-containing diet. In 3 of 6 patients, multiple biopsy specimens showed one sample with severe villous atrophy, Clinical and immunomorphologic features were strictly gluten dependent. The mucosal immune activation was elicited in vitro by gliadin, Only 4 patients had the typical HLA typing of celiac disease. Conclusions: Gluten-sensitive celiac-like symptoms may occur in patients with serum antiendomysium antibodies, apparently normal intestinal mucosa, and HL4 typing not commonly associated with celiac disease, These patients should undergo multiple biopsies, and signs of immunologic activation should be sought accurately; in the presence of mucosal immune activation, a trial with a gluten-free diet should be encouraged to detect gluten dependency, In vitro immunologic response of small intestinal mucosa to gliadin may support the diagnosis of gluten-sensitive enteropathy.

Gluten-sensitive disease with mild enteropathy / Picarelli, Antonio; L., Maiuri; Mazzilli, Maria Cristina; S., Coletta; P., Ferrante; F., Di Giovambattista; M., Greco; A., Torsoli; S., Auricchio. - In: GASTROENTEROLOGY. - ISSN 0016-5085. - 111:3(1996), pp. 608-616. [10.1053/gast.1996.v111.pm8780564]

Gluten-sensitive disease with mild enteropathy

PICARELLI, Antonio;MAZZILLI, Maria Cristina;
1996

Abstract

Background & Aims: Celiac disease is a permanent gluten intolerance strongly associated with HLA class II antigens and possibly showing milder changes of mucosal architecture, Ten patients with symptoms suggesting celiac disease and serum antiendomysium antibodies with normal mucosal architecture were studied. Methods: Immunohistochemical detection of mucosal immune activation and HLA typings were performed. Results, Mucosal immune activation, with normal mucosal architecture and normal gamma/delta(+) intraepithelial lymphocytes counts, was found on a gluten-containing diet. In 3 of 6 patients, multiple biopsy specimens showed one sample with severe villous atrophy, Clinical and immunomorphologic features were strictly gluten dependent. The mucosal immune activation was elicited in vitro by gliadin, Only 4 patients had the typical HLA typing of celiac disease. Conclusions: Gluten-sensitive celiac-like symptoms may occur in patients with serum antiendomysium antibodies, apparently normal intestinal mucosa, and HL4 typing not commonly associated with celiac disease, These patients should undergo multiple biopsies, and signs of immunologic activation should be sought accurately; in the presence of mucosal immune activation, a trial with a gluten-free diet should be encouraged to detect gluten dependency, In vitro immunologic response of small intestinal mucosa to gliadin may support the diagnosis of gluten-sensitive enteropathy.
1996
01 Pubblicazione su rivista::01a Articolo in rivista
Gluten-sensitive disease with mild enteropathy / Picarelli, Antonio; L., Maiuri; Mazzilli, Maria Cristina; S., Coletta; P., Ferrante; F., Di Giovambattista; M., Greco; A., Torsoli; S., Auricchio. - In: GASTROENTEROLOGY. - ISSN 0016-5085. - 111:3(1996), pp. 608-616. [10.1053/gast.1996.v111.pm8780564]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/256505
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