Serological tests in gluten sensitivity (nonceliac gluten intolerance)

J Clin Gastroenterol. 2012 Sep;46(8):680-5. doi: 10.1097/MCG.0b013e3182372541.

Abstract

Goals: To characterize the serological pattern of gluten sensitivity (GS) and to compare it with that found in celiac disease.

Background: GS has recently been identified as a new clinical entity included in the spectrum of gluten-related disorders, but it is still lacking of diagnostic markers.

Study: Sera from 78 patients with GS and 80 patients with celiac disease were retrospectively assessed for immunoglobulin (Ig)G/IgA antigliadin antibodies (AGA), IgG deamidated gliadin peptide antibodies (DGP-AGA), IgA tissue transglutaminase antibodies (tTGA), and IgA endomysial antibodies (EmA).

Results: IgG AGA were positive in 56.4% of GS patients and in 81.2% of celiac patients, with high antibody titers in both groups. IgA AGA were detected in 7.7% of GS patients and in 75% of celiac patients, showing lower enzyme-linked immunosorbent assay activities in GS than those found in celiac disease. Only 1 of the 78 patients with GS was positive for IgG DGP-AGA (detected in 88.7% of patients with celiac disease). IgA tTGA and IgA EmA were negative in all GS patients, whereas their positivity in celiac patients was 98.7% and 95%, respectively. Patients with GS displayed a variegated clinical picture with intestinal and extraintestinal symptoms (abdominal pain, bloating, diarrhea, constipation, foggy mind, tiredness, eczema/skin rash, headache, joint/muscle pain, numbness of legs/arms, depression, and anemia) together with normal or mildly abnormal small intestinal mucosa.

Conclusions: The serological pattern of GS is characterized by IgG AGA positivity in more than half of cases associated to IgA AGA in a few patients, but without EmA, tTGA, and DGP-AGA, which are the specific markers of celiac disease.

MeSH terms

  • Adolescent
  • Adult
  • Antibodies / blood
  • Biomarkers / blood
  • Celiac Disease / diagnosis
  • Celiac Disease / immunology
  • Female
  • Food Hypersensitivity / diagnosis*
  • Food Hypersensitivity / immunology*
  • Gliadin / immunology
  • Glutens / immunology*
  • Humans
  • Immunoglobulin A / blood
  • Immunoglobulin G / blood*
  • Intestinal Mucosa / immunology
  • Male
  • Middle Aged
  • Transglutaminases / immunology
  • Young Adult

Substances

  • Antibodies
  • Biomarkers
  • Immunoglobulin A
  • Immunoglobulin G
  • Glutens
  • Gliadin
  • Transglutaminases