Prevalence and natural history of potential celiac disease in adult patients

Biagi, Federico; Trotta, Lucia; Alfano, C; Balduzzi, Davide; Staffieri, Vincenza; Bianchi, Paola Ilaria; Marchese, A.; Vattiato, C.; Zilli, Alessandra; Luinetti, Ombretta; Gobbi, Paolo G.; Corazza, Gino Roberto

doi:10.3109/00365521.2013.777470

Cited by 63 publications

(73 citation statements)

References 17 publications

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“…6,7 Published literature on the natural history of PCD in adults is scarce. Biagi et al 8 recently report that there is maintenance of normal duodenal mucosal histology for many years, as well as spontaneous symptom resolution despite a gluten-containing diet (GCD), in a subset of adult patients with PCD; however, a randomized controlled trial from Finland suggests there is an unequivocal benefit of a gluten-free diet (GFD) in adult patients with PCD. 9 In the last decade, CD has been increasingly recognized in the predominant wheat-eating population of northern India.…”

Section: Introductionmentioning

confidence: 99%

Short‐term prognosis of potential celiac disease in Indian patients

et al. 2016

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Background: Progression of potential celiac disease (PCD) to overt celiac disease (CD) has been described in some studies from the Western Hemisphere. There are no Asian data on this aspect of CD. Objective: We aimed to study the short-term histological course of PCD in Indian patients. Methods: Patients with PCD were prospectively identified by screening relatives of patients with CD, the diarrheal subtype of irritable bowel syndrome (IBS-D) and patients with iron deficiency anemia (IDA). Patients with serology that was positive for immunoglobulin A antibodies against tissue transglutaminase (IgA anti-tTG) were subjected to endoscopy with duodenal biopsy. PCD was defined as a Marsh-0 to Marsh-II lesion on duodenal biopsy, along with positive IgA tTG serology. Retesting for serology and histology was done at 6-month intervals, for 12 months. Results: We diagnosed 57 patients (23 male) of mean age 28.7 years (range: 4-73 yrs) as having PCD. Of these 57 patients, 28 were identified by screening 192 first-degree relatives of 55 index cases of CD, while the remaining 29 had either IBS-D or IDA. Duodenal biopsy showed Marsh-0, Marsh-I and Marsh-II changes in 28, 27 and 2 patients, respectively. At 6 months, 12 patients became seronegative. The remaining 45 patients continued to be seropositive at the 12-month time point. Histological progression to Marsh-III occurred in only four patients, while progression from Marsh-0 to either Marsh-I or Marsh-II occurred in six patients and one patient, respectively; but 14 patients with Marsh-I did show regression to Marsh-0. Of the two patients who were initially Marsh-II, one remained so upon follow up and one showed regression to Marsh-0. Conclusions: Our data suggested that despite the fact that nearly 80% of the patients diagnosed to have PCD continue to remain seropositive for tTG 12 months later, histological progression to Marsh-III occurred in only 7% of patients over the same time period. These observations do not justify starting a gluten-free diet in all patients with PCD, in India.

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Section: Introductionmentioning

confidence: 99%

Short‐term prognosis of potential celiac disease in Indian patients

et al. 2016

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“…47,[52][53][54] A recent randomized study also shows that apparently asymptomatic EMA-positive subjects seem to benefit from their serological screening and subsequent GFD, 55 thereby supporting earlier evidence from Dickey et al; 56 however, some authors have suggested that EMA positivity in individuals with normal mucosa constitutes a separate entity (potential CD), different from CD. 57 A strict GFD sets major limitations on daily life and it is expensive and difficult to maintain. 58,59 Furthermore, removal of gluten from baked products makes them less palatable than comparable products in the normal diet.…”

Section: The Gfd: ''That a Treatment Is Available''mentioning

confidence: 99%

Screening for celiac disease in the general population and in high‐risk groups

et al. 2015

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Background: Celiac disease (CD) occurs in approximately 1% of the Western population. It is a lifelong disorder that is associated with impaired quality of life (QOL) and an excessive risk of comorbidity and death. Objectives: To review the literature on screening for CD in relation to the current World Health Organization (WHO) criteria for mass screening. Methods: We performed a PubMed search to identify indexed papers on CD screening with a publication date from 1900 until 1 June 2014. When we deemed an abstract relevant, we read the corresponding paper in detail. Results: CD fulfills several WHO criteria for mass screening (high prevalence, available treatment and difficult clinical detection), but it has not yet been established that treatment of asymptomatic CD may reduce the excessive risk of severe complications, leading to higher QOL nor that it is cost-effective. Conclusions: Current evidence is not sufficient to support mass screening for CD, but active case-finding may be appropriate, as we recognize that most patients with CD will still be missed by this strategy. Although proof of benefit is still lacking, screening for CD may be appropriate in high-risk groups.

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“…Since poor orientation precluded TH analysis of 81 biopsies, 1994 duodenal biopsies were analysed with both DM and TH. A total of 654 patients were affected by CD (281 on a gluten-containing diet and 534 on a gluten-free diet—161 patients underwent duodenal biopsy on both diets), 39 by complicated CD, 36 by potential CD (ie, positive endomysial antibodies but architecturally preserved duodenal mucosa13), 14 by common variable immunodeficiency-associated enteropathy,14 13 by Whipple's disease, four by Crohn's disease, three by autoimmune enteropathy, three by eosinophilic gastroenteritis, two by olmesartan enteropathy, one by Behçet's disease; the remaining 768 patients were affected by functional disorders. A thorough clinical description of all these patients is beyond the scope of this study.…”

Section: Resultsmentioning

confidence: 99%