Disappearance of endomysial antibodies in treated celiac disease does not indicate histological recovery

Dickey, William; Hughes, D.; McMillan, S A

doi:10.1111/j.1572-0241.2000.01838.x

Cited by 135 publications

(77 citation statements)

References 16 publications

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“…While detailed dietary analysis may be the most accurate way to detect continued gluten ingestion, this is labor-intensive, and is associated with significant interobserver variability [13]. Previous studies have emphasized the limitations of follow-up antibody testing of patients [7,26]. It has also been suggested that permeability testing may offer important clinical information in the follow-up of patients with celiac disease [27].…”

Section: Discussionmentioning

confidence: 96%

A Comparison of Antibody Testing, Permeability Testing, and Zonulin Levels with Small-Bowel Biopsy in Celiac Disease Patients on a Gluten-Free Diet

et al. 2009

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Active celiac disease is associated with positive endomysial (EMA) and tissue transglutaminase (TTG) antibodies, elevated zonulin levels, and increased intestinal permeability. There is little known about what happens to these immunologic and structural abnormalities in patients on a gluten-free diet and their correlation with small-bowel biopsy changes. Adult patients previously diagnosed with celiac disease and on a gluten-free diet for greater than 1 year were considered for the study. All patients underwent the following: measurement of EMA and TTG antibodies, serum zonulin levels, intestinal permeability (IP) testing with lactulose/mannitol ratios, food diary analysis for gluten ingestion and small- bowel biopsy. A total of 21 patients on a gluten-free diet for a mean of 9.7 years completed the study. There were ten patients who had normalization of intestinal biopsies, IP and TTG, and EM antibodies. Six patients had Marsh type 2 or 3 lesions and all had either abnormal IP (5/6) or TTG antibody (4/6). In patients with Marsh type 3 lesions, there was a correlation between IP and zonulin levels. A subgroup of patients with celiac disease on a gluten-free diet has complete normalization of intestinal biopsies, intestinal permeability defects, and antibody levels. Patients with Marsh type 3 lesions have abnormal TTG antibodies and intestinal permeability with zonulin levels that correlate with IP. These abnormalities may be due to continued gluten ingestion. Further study is needed to determine the clinical utility of TTG antibodies and IP testing in following patients with celiac disease.

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Section: Discussionmentioning

confidence: 96%

A Comparison of Antibody Testing, Permeability Testing, and Zonulin Levels with Small-Bowel Biopsy in Celiac Disease Patients on a Gluten-Free Diet

et al. 2009

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“…Mucosal abnormalities in children with CD on a GFD have been seen in the setting of clinical remission; however, they are thought to be uncommon ( 16,17 ). Anti-endomysial antibodies have been shown to be poor markers of ongoing mucosal injury, including in an adolescent population with poor dietary compliance ( 18,19 ). Serum IgA-class tTG antibodies have also been disappointing in adult follow-up data ( 20,21 ).…”

Section: Introductionmentioning

confidence: 96%

Can Celiac Serology Alone be Used as a Marker of Duodenal Mucosal Recovery in Children with Celiac Disease on a Gluten-Free Diet?

Bannister

Cameron

et al. 2014

American Journal of Gastroenterology

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“…The accuracy of the test is also subject to interobserver variability because it is an immunofluorescence assay. Several studies have also suggested that decreasing or vanishing titers of anti-EmA correlate with gluten-free dietary compliance but that decreasing titers do not correlate with histologic recovery [15]. Due to its current availability, however, EmA testing is recommended as a routine screening tool for the diagnosis of celiac disease.…”

Section: Celiac Disease Assaysmentioning

confidence: 96%

Malabsorption testing: A review

Ginsburg

Janefalkar²,

Rubin³

et al. 2000

Curr Gastroenterol Rep

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Malabsorption syndromes often present diagnostic dilemmas to even the most experienced clinicians. Several malabsorption screening tests are available, but d-xylose testing is our initial screening method of choice. Recent innovations such as serum assays for antibodies associated with celiac sprue are improving the work-up of patients with suspected malabsorption. In addition, physicians are applying technological advances in imaging to determine the underlying pathologies responsible for the occurrence of malabsorption and maldigestion. Breath testing remains a controversial modality in the work-up of patients with malabsorption. Tubeless tests of pancreatic function are also the subject of debate due to a lack of sensitivity for diagnosing mild to moderate chronic pancreatic insufficiency. This review identifies and provides critical analysis of new developments in the field of malabsorption testing. The authors also provide a clinical algorithm for diagnosing malabsorption.

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Disappearance of endomysial antibodies in treated celiac disease does not indicate histological recovery

Cited by 135 publications

References 16 publications

A Comparison of Antibody Testing, Permeability Testing, and Zonulin Levels with Small-Bowel Biopsy in Celiac Disease Patients on a Gluten-Free Diet

A Comparison of Antibody Testing, Permeability Testing, and Zonulin Levels with Small-Bowel Biopsy in Celiac Disease Patients on a Gluten-Free Diet

Can Celiac Serology Alone be Used as a Marker of Duodenal Mucosal Recovery in Children with Celiac Disease on a Gluten-Free Diet?

Malabsorption testing: A review

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