Prevalence of celiac disease in patients with severe food allergy

Pillon, Roberto; Ziberna, Fabiana; Badina, Laura; Ventura, Alessandro; Longo, Giorgio; Quaglia, Sara; Leo, Luigina De; Vatta, Serena; Martelossi, Stefano; Patano, G.; Not, Tarcisio; Berti, Irene

doi:10.1111/all.12692

Cited by 25 publications

(15 citation statements)

References 23 publications

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“…It also underlines a common predisposition to develop autoimmune disease, as showed by the fact that about 10% of patients with positive tTGIgA in our study had either type 1 diabetes or an autoimmune thyroiditis. On the contrary, our study does not support the hypothesis of a link between atopy and CD, in agreement with previous studies [34, 35], nor of a link between food allergy and CD, as reported in recent studies [36]. …”

Section: Discussionsupporting

confidence: 74%

Identifying True Celiac Disease and Wheat Allergy in the Era of Fashion Driven Gluten-Free Diets

Spoerl

Bastid²,

Ramadan

et al. 2019

Int Arch Allergy Immunol

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Background: Diagnosing both celiac disease (CD) and wheat allergy (WA) might be challenging due to the increasingly popular gluten-free diets. Objectives: This study investigates the value of anti-tissue transglutaminase IgA (tTGIgA) and wheat-specific IgE (WIgE), and identifies clinical and serological features associated with CD and WA. Method: Serological markers of autoimmunity and allergy along with medical charts of patients assessed for tTGIgA and WIgE between 2010 and 2016 were evaluated. Results: During the last years, an increasing number of patients have been tested for tTGIgA, while the number of positive results decreased linearly. Among the 2,965 patients included, 128 patients showed at least once a positive tTGIgA. All patients with tTGIgA levels higher than the 12-fold upper normal limit had CD. The ratio of tTGIgA/total IgA did not perform better as a diagnostic test for CD compared to tTGIgA. tTGIgA and anti-nuclear antibodies were significantly associated. WA was only rarely investigated, particularly in adults. However, positive WIgE were found in nearly 50% of the cases. WIgE and tTGIgA values were negatively correlated. Conclusions: tTGIgA were increasingly tested, while the rate of positive results decreased in recent years, possibly reflecting the impact of current alimentary trends on clinical practice. Associated autoimmune disease was frequently found in CD. High levels of tTGIgA accurately predicted CD diagnosis. WA was rarely investigated and deserves more attention, in particular in children with atopic background. WA does not seem to be associated with CD.

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Section: Discussionsupporting

confidence: 74%

Identifying True Celiac Disease and Wheat Allergy in the Era of Fashion Driven Gluten-Free Diets

Spoerl

Bastid²,

Ramadan

et al. 2019

Int Arch Allergy Immunol

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“…The term gluten sensitivity may imply hypersensitivity or allergy . Actually, CD was found to be 5‐fold higher in patients with severe food allergy . However, we could not find an evidence to support a type I hypersensitivity in CD .…”

Section: Celiac Diseasecontrasting

confidence: 58%

Gluten sensitivities and the allergist: Threshing the grain from the husks

Burkhardt

Chapa-Rodríguez

Bahna

2017

Allergy

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Abstract"Gluten sensitivity" has become commonplace among the public. Wheat allergy (WA) and celiac disease (CD) are well-defined entities, but are becoming a fraction of individuals following a gluten-free diet (GFD). Wheat allergy has a prevalence of <0.5%. Wheat, specifically its omega-5 gliadin fraction, is the most common allergen implicated in food-dependent, exercise-induced anaphylaxis. CD is a non-IgE hypersensitivity to certain cereal proteins: gluten in wheat, secalin in rye, hordein in barley, and to a lesser extent avenin in oat. It is a rare disease, with an estimated prevalence that varied widely geographically, being higher in Northern Europe and the African Saharawi region than in South-East Asia. In addition to suggestive symptoms, serologic testing has high diagnostic reliability and biopsy is a confirmatory procedure. Patients with CD have extra-intestinal autoimmune comorbid conditions more frequently than expected. A third entity is nonceliac gluten sensitivity, which has been created because of the increasing number of subjects who claim a better quality of life or improvement of their variety of symptoms on switching to a GFD.The phenomenon is being fueled by the media and exploited by the industry. The lack of a specific objective test has been raising substantial controversy about this entity. Allergists and gastroenterologists need to pay attention to the multitudes of individuals who elect to follow a GFD. Many such subjects might have WA, CD, or another illness. Providing them with appropriate evaluation and specific management would be of great advantages, medically and economically. K E Y W O R D Sceliac disease, gluten sensitivity, gluten-free diet, nonceliac gluten sensitivity, wheat allergy 1 | INTRODUCTION "Gluten" has become part of everyday vocabulary by the public, a popular topic by the media, and is being exploited by the food industry. Three wheat-related disorders have been described, namely wheat allergy (WA), celiac disease (CD), and the new entity nonceliac gluten sensitivity (NCGS). The objective of this paper was to differentiate between these 3 disorders regarding epidemiology, manifestations, pathogenesis, diagnosis, and management. As a timely topic, "gluten sensitivity" stimulated the publication of multiple reviews, mainly in the gastroenterology and nutrition literatures, but not so in the allergy literature. Fueled by the media and the food industry's promotion of gluten-free products, the number of subjects claiming gluten-related illnesses has been exponentially increasing and they are seeking or referred for allergy evaluation.

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“…Recent studies showed potential associations between atopic conditions and the risk of CD, 39,40,43 but the results have been inconsistent. For example, Pillon et al 44 reported that food allergy was associated with CD in 5% of children who had severe food allergy and 0.8% of children with mild food allergy. Another study, based on a large national data set that uses ICD codes, found a potential association between asthma and the risk of CD.…”

Section: Discussionmentioning

confidence: 99%