Clinical, HLA, and Small Bowel Immunohistochemical Features of Children with Positive Serum Antiendomysium Antibodies and Architecturally Normal Small Intestinal Mucosa

Paparo, Francesco; Petrone, Emma; Tosco, Antonella; Maglio, Maria; Borrelli, Melissa; Salvati, V.M.; Miele, Erasmo; Greco, Luigi; Auricchio, Salvatore; Troncone, Riccardo

doi:10.1111/j.1572-0241.2005.41134.x

Cited by 104 publications

(70 citation statements)

References 19 publications

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“…However, this technique has limited diagnostic utility due to the unavailability of formalin-fixed, paraffin-embedded tissue. 82 The predictive value of histology is much greater in the presence of villous atrophy (mild, partial or subtotal) (Figure 1c-d-e-f). However, it should be remembered that other disorders, including common variable immunodeficiency, autoimmune enteropathy, Whipple disease and eosinophilic gastroenteritis, can cause nongluten-dependent villous atrophy.…”

Section: Diagnostic Criteriamentioning

confidence: 96%

Celiac disease: diagnostic criteria in progress

2011

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Until a few years ago, celiac disease (CD) was thought to be a rare food intolerance that was confined to childhood and characterized by severe malabsorption and flat intestinal mucosa. Currently, CD is regarded as an autoimmune disorder that is common in the general population (affecting 1 in 100 individuals), with possible onset at any age and with many possible presentations. The identification of CD is challenging because it can begin not only with diarrhea and weight loss but also with atypical gastrointestinal (constipation and recurrent abdominal pain) and extra-intestinal symptoms (anemia, raised transaminases, osteoporosis, recurrent miscarriages, aphthous stomatitis and associated autoimmune disorders), or it could be completely symptomless. Over the last 20 years, the diagnostic accuracy of serology for CD has progressively increased with the development of highly reliable tests, such as the detection of IgA tissue transglutaminase and antiendomysial and IgG antideamidated gliadin peptide antibodies. The routine use of antibody markers has allowed researchers to discover a very high number of 'borderline' cases, characterized by positive serology and mild intestinal lesions or normal small intestine architecture, which can be classified as potential CD. Therefore, it is evident that the 'old celiac disease' with flat mucosa is only a part of the spectrum of CD. It is possible that serology could identify CD in its early stages, before the appearance of severe intestinal damage. In cases with a positive serology but with mild or absent intestinal lesions, the detection of HLA-DQ2 and HLA-DQ8 can help reinforce or exclude the diagnosis of gluten sensitivity.

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Section: Diagnostic Criteriamentioning

confidence: 96%

Celiac disease: diagnostic criteria in progress

2011

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“…+ mononuclear cells in lamina propria of potential CD mucosa as well as the evaluation of cell density were performed as previously reported ( 21 ).…”

Section: Immunohistochemical Detection Of Cd25mentioning

confidence: 99%

In the Intestinal Mucosa of Children With Potential Celiac Disease IL-21 and IL-17A are Less Expressed than in the Active Disease

Borrelli¹,

Gianfrani

Lania³

et al. 2016

American Journal of Gastroenterology

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“…From 409 c hildren who were positive for c eliac -related antibodies, 24 (5.9%) of the individuals were reported to have an arc hitec turally normal small intestinal muc osa, 46% (11 of these 24 patients) had inc reased CD3+ intraepithelial lymphoc ytes, and 71% (17 of the 24) had an inc reased density of gamma-delta + c ells [15] . In 17 of these 24 persons (70%), the number of lamina propria CD25+ c ells was inc reased, and/or the expression of ICAM-1 and c rypt HLA-DR was enhanc ed.…”

Section: Geneticsmentioning

confidence: 99%

Recent advances in celiac disease

Freeman

Chopra²,

Clandinin³

et al. 2011

WJG

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Celiac disease now affects about one person in a hundred in Europe and North America. In this review, we consider a number of important and exciting recent developments, such as clinical associations, HLA-DQ2 and HLA-DQ8 predispositions, the concept of potential celiac disease, the use of new imaging/endoscopy techniques, and the development of refractory disease. This review will be of use to all internists, pediatricians and gastroenterologists.

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Clinical, HLA, and Small Bowel Immunohistochemical Features of Children with Positive Serum Antiendomysium Antibodies and Architecturally Normal Small Intestinal Mucosa

Cited by 104 publications

References 19 publications

Celiac disease: diagnostic criteria in progress

Celiac disease: diagnostic criteria in progress

In the Intestinal Mucosa of Children With Potential Celiac Disease IL-21 and IL-17A are Less Expressed than in the Active Disease

Recent advances in celiac disease

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