Abstract
Background: Non-celiac gluten sensitivity (NCGS) is still an undefined syndrome with several unsettled issues despite the increasing awareness of its existence. We carried out a prospective survey on NCGS in Italian centers for the diagnosis of gluten-related disorders, with the aim of defining the clinical picture of this new syndrome and to establish roughly its prevalence compared with celiac disease. Methods: From November 2012 to October 2013, 38 Italian centers (27 adult gastroenterology, 5 internal medicine, 4 pediatrics, and 2 allergy) participated in this prospective survey. A questionnaire was used in order to allow uniform and accurate collection of clinical, biochemical, and instrumental data. Results: In total, 486 patients with suspected NCGS were identified in this 1-year period. The female/male ratio was 5.4 to 1, and the mean age was 38 years (range 3-81). The clinical picture was characterized by combined gastrointestinal (abdominal pain, bloating, diarrhea and/or constipation, nausea, epigastric pain, gastroesophageal reflux, aphthous stomatitis) and systemic manifestations (tiredness, headache, fibromyalgia-like joint/muscle pain, leg or arm numbness, 'foggy mind,' dermatitis or skin rash, depression, anxiety, and anemia). In the large majority of patients, the time lapse between gluten ingestion and the appearance of symptoms varied from a few hours to 1 day. The most frequent associated disorders were irritable bowel syndrome (47%), food intolerance (35%) and IgE-mediated allergy (22%). An associated autoimmune disease was detected in 14% of cases. Regarding family history, 18% of our patients had a relative with celiac disease, but no correlation was found between NCGS and positivity for HLA-DQ2/-DQ8. IgG anti-gliadin antibodies were detected in 25% of the patients tested. Only a proportion of patients underwent duodenal biopsy; for those that did, the biopsies showed normal intestinal mucosa (69%) or mild increase in intraepithelial lymphocytes (31%). The ratio between suspected NCGS and new CD diagnoses, assessed in 28 of the participating centers, was 1.15 to 1. Conclusions: This prospective survey shows that NCGS has a strong correlation with female gender and adult age. Based on our results, the prevalence of NCGS seems to be only slightly higher than that of celiac disease. Please see related article http://www.biomedcentral.com/1741-7015/12/86.
| Original language | English |
|---|---|
| Article number | 85 |
| Journal | BMC Medicine |
| Volume | 12 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - May 23 2014 |
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Keywords
- Anti-gliadin antibodies
- Celiac disease
- Clinical picture
- Duodenal biopsy
- Non-celiac gluten sensitivity
- Prospective survey
ASJC Scopus subject areas
- Medicine(all)
Cite this
An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. / Volta, Umberto; Bardella, Maria T.; Calabrò, Antonino; Troncone, Riccardo; Corazza, Gino R.; Bagnato, Carmela; Belcari, Claudio; Bellantoni, Antonella; Caio, Giacomo; Calella, Francesca; Cappello, Maria; Ciacci, Carolina; D'Agate, Cinzia; De Vitis, Italo; Di Sabatino, Antonio; Fava, Gianmarco; Frau, Maria Rita; Fugazza, Alessandro; Grassi, Stefano Andrea; Larcinese, Giuseppina; Latella, Giovanni; Lauri, Adriano; Lauria, Angelo; Lenoci, Nicoletta; Lopez Rios, Norma Beatriz; Macchia, Donatella; Minelli, Mauro; Molinari, Beba; Morelli, Olivia; Mumolo, Maria Gloria; Niccoli, Giovanni; Pacenza, Caterina; Pallone, Francesco; Parente, Fabrizio; Pulitanò, Raffaella; Pumpo, Rossella; Riegler, Gabriele; Rispo, Antonio; Rispoli, Flavio Romolo; Tedone, Francesco; Valiante, Flavio; Viviani, Giovanni; Satta, Paolo Usai.
In: BMC Medicine, Vol. 12, No. 1, 85, 23.05.2014.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity
AU - Volta, Umberto
AU - Bardella, Maria T.
AU - Calabrò, Antonino
AU - Troncone, Riccardo
AU - Corazza, Gino R.
AU - Bagnato, Carmela
AU - Belcari, Claudio
AU - Bellantoni, Antonella
AU - Caio, Giacomo
AU - Calella, Francesca
AU - Cappello, Maria
AU - Ciacci, Carolina
AU - D'Agate, Cinzia
AU - De Vitis, Italo
AU - Di Sabatino, Antonio
AU - Fava, Gianmarco
AU - Frau, Maria Rita
AU - Fugazza, Alessandro
AU - Grassi, Stefano Andrea
AU - Larcinese, Giuseppina
AU - Latella, Giovanni
AU - Lauri, Adriano
AU - Lauria, Angelo
AU - Lenoci, Nicoletta
AU - Lopez Rios, Norma Beatriz
AU - Macchia, Donatella
AU - Minelli, Mauro
AU - Molinari, Beba
AU - Morelli, Olivia
AU - Mumolo, Maria Gloria
AU - Niccoli, Giovanni
AU - Pacenza, Caterina
AU - Pallone, Francesco
AU - Parente, Fabrizio
AU - Pulitanò, Raffaella
AU - Pumpo, Rossella
AU - Riegler, Gabriele
AU - Rispo, Antonio
AU - Rispoli, Flavio Romolo
AU - Tedone, Francesco
AU - Valiante, Flavio
AU - Viviani, Giovanni
AU - Satta, Paolo Usai
PY - 2014/5/23
Y1 - 2014/5/23
N2 - Background: Non-celiac gluten sensitivity (NCGS) is still an undefined syndrome with several unsettled issues despite the increasing awareness of its existence. We carried out a prospective survey on NCGS in Italian centers for the diagnosis of gluten-related disorders, with the aim of defining the clinical picture of this new syndrome and to establish roughly its prevalence compared with celiac disease. Methods: From November 2012 to October 2013, 38 Italian centers (27 adult gastroenterology, 5 internal medicine, 4 pediatrics, and 2 allergy) participated in this prospective survey. A questionnaire was used in order to allow uniform and accurate collection of clinical, biochemical, and instrumental data. Results: In total, 486 patients with suspected NCGS were identified in this 1-year period. The female/male ratio was 5.4 to 1, and the mean age was 38 years (range 3-81). The clinical picture was characterized by combined gastrointestinal (abdominal pain, bloating, diarrhea and/or constipation, nausea, epigastric pain, gastroesophageal reflux, aphthous stomatitis) and systemic manifestations (tiredness, headache, fibromyalgia-like joint/muscle pain, leg or arm numbness, 'foggy mind,' dermatitis or skin rash, depression, anxiety, and anemia). In the large majority of patients, the time lapse between gluten ingestion and the appearance of symptoms varied from a few hours to 1 day. The most frequent associated disorders were irritable bowel syndrome (47%), food intolerance (35%) and IgE-mediated allergy (22%). An associated autoimmune disease was detected in 14% of cases. Regarding family history, 18% of our patients had a relative with celiac disease, but no correlation was found between NCGS and positivity for HLA-DQ2/-DQ8. IgG anti-gliadin antibodies were detected in 25% of the patients tested. Only a proportion of patients underwent duodenal biopsy; for those that did, the biopsies showed normal intestinal mucosa (69%) or mild increase in intraepithelial lymphocytes (31%). The ratio between suspected NCGS and new CD diagnoses, assessed in 28 of the participating centers, was 1.15 to 1. Conclusions: This prospective survey shows that NCGS has a strong correlation with female gender and adult age. Based on our results, the prevalence of NCGS seems to be only slightly higher than that of celiac disease. Please see related article http://www.biomedcentral.com/1741-7015/12/86.
AB - Background: Non-celiac gluten sensitivity (NCGS) is still an undefined syndrome with several unsettled issues despite the increasing awareness of its existence. We carried out a prospective survey on NCGS in Italian centers for the diagnosis of gluten-related disorders, with the aim of defining the clinical picture of this new syndrome and to establish roughly its prevalence compared with celiac disease. Methods: From November 2012 to October 2013, 38 Italian centers (27 adult gastroenterology, 5 internal medicine, 4 pediatrics, and 2 allergy) participated in this prospective survey. A questionnaire was used in order to allow uniform and accurate collection of clinical, biochemical, and instrumental data. Results: In total, 486 patients with suspected NCGS were identified in this 1-year period. The female/male ratio was 5.4 to 1, and the mean age was 38 years (range 3-81). The clinical picture was characterized by combined gastrointestinal (abdominal pain, bloating, diarrhea and/or constipation, nausea, epigastric pain, gastroesophageal reflux, aphthous stomatitis) and systemic manifestations (tiredness, headache, fibromyalgia-like joint/muscle pain, leg or arm numbness, 'foggy mind,' dermatitis or skin rash, depression, anxiety, and anemia). In the large majority of patients, the time lapse between gluten ingestion and the appearance of symptoms varied from a few hours to 1 day. The most frequent associated disorders were irritable bowel syndrome (47%), food intolerance (35%) and IgE-mediated allergy (22%). An associated autoimmune disease was detected in 14% of cases. Regarding family history, 18% of our patients had a relative with celiac disease, but no correlation was found between NCGS and positivity for HLA-DQ2/-DQ8. IgG anti-gliadin antibodies were detected in 25% of the patients tested. Only a proportion of patients underwent duodenal biopsy; for those that did, the biopsies showed normal intestinal mucosa (69%) or mild increase in intraepithelial lymphocytes (31%). The ratio between suspected NCGS and new CD diagnoses, assessed in 28 of the participating centers, was 1.15 to 1. Conclusions: This prospective survey shows that NCGS has a strong correlation with female gender and adult age. Based on our results, the prevalence of NCGS seems to be only slightly higher than that of celiac disease. Please see related article http://www.biomedcentral.com/1741-7015/12/86.
KW - Anti-gliadin antibodies
KW - Celiac disease
KW - Clinical picture
KW - Duodenal biopsy
KW - Non-celiac gluten sensitivity
KW - Prospective survey
UR - http://www.scopus.com/inward/record.url?scp=84901301250&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84901301250&partnerID=8YFLogxK
U2 - 10.1186/1741-7015-12-85
DO - 10.1186/1741-7015-12-85
M3 - Article
C2 - 24885375
AN - SCOPUS:84901301250
VL - 12
JO - BMC Medicine
JF - BMC Medicine
SN - 1741-7015
IS - 1
M1 - 85
ER -