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Gastroenterology. 1993 May;104(5):1263-72.

Intestinal antibody pattern of celiac disease: occurrence in patients with normal jejunal biopsy histology.

Author information

1
Gastrointestinal Unit, University of Edinburgh, Scotland.

Abstract

BACKGROUND:

Patients with celiac disease have immunoglobulin (Ig) M antibodies and IgA antigliadin antibody in gut secretions; this pattern of intestinal immunity may be a marker of latent celiac disease. Its frequency in patients referred for jejunal biopsy has been examined.

METHODS:

Serum IgG and IgA antigliadin antibody, jejunal fluid IgA and IgM antibodies to gliadin, ovalbumin and beta lactoglobulin, and jejunal fluid IgA and IgM concentrations were measured by enzyme-linked immunosorbent assay.

RESULTS:

Seventeen of 19 celiac patients on normal diet and 16 of 23 on gluten-free diet had the celiaclike antibody pattern, as did 41 of 217 other patients. Jejunal biopsy histology had been classified as normal in 38 of these, with minor abnormalities in 3; however, intraepithelial lymphocyte (IEL) counts were high in 13 cases. Trial of a gluten-free diet produced clinical improvement in 6 of 7 antibody-positive patients. After extra dietary gluten, one developed subtotal villous atrophy.

CONCLUSIONS:

The celiaclike intestinal antibody pattern and a high IEL count may be markers of latent gluten-sensitive enteropathy; some of these patients are clinically gluten sensitive in the absence of enteropathy.

PMID:
8482440
DOI:
10.1016/0016-5085(93)90333-8
[Indexed for MEDLINE]

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