Gluten-sensitive disease with mild enteropathy

A. Picarelli, L. Maiuri, M. C. Mazzilli, S. Coletta, P. Ferrante, F. Di Giovambattista, M. Greco, A. Torsoli, S. Auricchio

Research output: Contribution to journalArticle

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Abstract

Background and Aims: Celiac disease is a permanent gluten intolerance strongly associated with HLA class II antigens and possibly showing milder changes of mucosal architecture. Ten patients with symptoms suggesting celiac disease and serum antiendomysium antibodies with normal mucosal architecture were studied. Methods: Immunohistochemical detection of mucosal immune activation and HLA typings were performed. Results: Mucosal immune activation, with normal mucosal architecture and normal τ/δ+ intraepithelial lymphocytes counts, was found on a gluten-containing diet. In 3 of 6 patients, multiple biopsy specimens showed one sample with severe villous atrophy. Clinical and immunomorphologic features were strictly gluten dependent. The mucosal immune activation was elicited in vitro by gliadin. Only 4 patients had the typical HLA typing of celiac disease. Conclusions: Gluten-sensitive celiac-like symptoms may occur in patients with serum antiendomysium antibodies, apparently normal intestinal mucosa, and HLA typing not commonly associated with celiac disease. These patients should undergo multiple biopsies, and signs of immunologic activation should be sought accurately; in the presence of mucosal immune activation, a trial with a gluten-free diet should be encouraged to detect gluten dependency. In vitro immunologic response of small intestinal mucosa to gliadin may support the diagnosis of gluten-sensitive enteropathy.

Original languageEnglish
Pages (from-to)608-616
Number of pages9
JournalGastroenterology
Volume111
Issue number3
Publication statusPublished - 1996

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Glutens
Celiac Disease
Histocompatibility Testing
Gliadin
Intestinal Mucosa
Biopsy
Gluten-Free Diet
Antibodies
Histocompatibility Antigens Class II
Lymphocyte Count
HLA Antigens
Serum
Abdomen
Atrophy
Diet
In Vitro Techniques

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Picarelli, A., Maiuri, L., Mazzilli, M. C., Coletta, S., Ferrante, P., Di Giovambattista, F., ... Auricchio, S. (1996). Gluten-sensitive disease with mild enteropathy. Gastroenterology, 111(3), 608-616.

Gluten-sensitive disease with mild enteropathy. / Picarelli, A.; Maiuri, L.; Mazzilli, M. C.; Coletta, S.; Ferrante, P.; Di Giovambattista, F.; Greco, M.; Torsoli, A.; Auricchio, S.

In: Gastroenterology, Vol. 111, No. 3, 1996, p. 608-616.

Research output: Contribution to journalArticle

Picarelli, A, Maiuri, L, Mazzilli, MC, Coletta, S, Ferrante, P, Di Giovambattista, F, Greco, M, Torsoli, A & Auricchio, S 1996, 'Gluten-sensitive disease with mild enteropathy', Gastroenterology, vol. 111, no. 3, pp. 608-616.
Picarelli A, Maiuri L, Mazzilli MC, Coletta S, Ferrante P, Di Giovambattista F et al. Gluten-sensitive disease with mild enteropathy. Gastroenterology. 1996;111(3):608-616.
Picarelli, A. ; Maiuri, L. ; Mazzilli, M. C. ; Coletta, S. ; Ferrante, P. ; Di Giovambattista, F. ; Greco, M. ; Torsoli, A. ; Auricchio, S. / Gluten-sensitive disease with mild enteropathy. In: Gastroenterology. 1996 ; Vol. 111, No. 3. pp. 608-616.
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AU - Maiuri, L.

AU - Mazzilli, M. C.

AU - Coletta, S.

AU - Ferrante, P.

AU - Di Giovambattista, F.

AU - Greco, M.

AU - Torsoli, A.

AU - Auricchio, S.

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