Screening for celiac disease in non-Hodgkin's lymphoma patients: a serum anti-transglutaminase-based approach

Several studies have shown the existence of an association between celiac disease (CD) and non-Hodgkin's lymphoma (NHL). Our aim was to evaluate the usefulness of the serum anti-tissue transglutaminase (anti-tTG) antibody assay in screening for CD in consecutive NHL patients. In all, 80 consecutive patients (median age 61 years) with a new diagnosis of NHL were included. To compare the frequency of CD and of positive results for the anti-tTG assay, we enrolled 500 blood donors. In all patients serum anti-tTG was determined with two different ELISA: one based on tTG from guinea pig (gp-tTG) and the other based on human recombinant t-TG (h-tTG) as the antigens. Serum anti-endomysial antibodie…

Nutrition: Searching for the immunological basis of wheat sensitivity

A new study has advanced our knowledge on the pathogenesis of noncoeliac wheat sensitivity (NCWS), implicating the activation of innate immunity markers and immunological mechanisms at the basis of NCWS. However, limitations in the design of studies performed in this field will need addressing to help identify the root cause of NCWS.

ANEMIA RESISTANT TO THE GLUTEN-FREE DIET IN CELIAC DISEASE PATIENTS: IS IT JUST A MALABSORPTION PROBLEM?: ANEMIA RESISTANT TO GFD IN CD PATIENTS

Autoimmune enteropathy and colitis in an adult patient

The presence of circulating autoantibodies to gut enterocytes has been very rarely described in adults and is considered a possible cause of refractory sprue. Our aims was to describe the case of an adult patient with serum anti-enterocyte autoantibodies associated with a clinical picture characterized by involvement of both the small intestine and colon. A female, age 50, had suffered from diarrhea with mucus and blood, abdominal pain, thinness, anemia, and leukopenia since the age of 20. She also suffered from HCV infection and had mild chronic hepatitis. Family history was positive for autoimmunity. Symptoms were reported to worsen after eating gluten-containing foods, but anti-transglut…

Diagnostic Yield of 2 Strategies for Adult Celiac Disease Identification in Primary Care

Goals: To compare the diagnostic yield and cost-consequences of 2 strategies, screening regardless of symptoms versus case finding (CF), using a point-of-care test (POCT), for the detection of celiac disease (CD) in primary care, to bridge the diagnostic gap of CD in adults. Materials and Methods: All subjects under 75 years of age who consecutively went to their general practitioners’ offices were offered POCT for anti-transglutaminase immunoglobulin A antibodies. The POCT was performed on all subjects who agreed, and then a systematic search for symptoms or conditions associated with higher risk for CD was performed, immediately after the test but before knowing the test results. The 2 …

Improving the diagnostic approach to celiac disease: Experience from a regional network

Background: Celiac disease (CD) is still underestimated. To close this diagnostic gap, the Health Sicilian Authorities have constituted the "Sicilian Network for CD". Aims: A) To verify the quality of the current diagnostic approach using the data sheet of the Network. B) To evaluate the clinical, serologic and histologic data of new diagnoses in the context of the Network METHODS: We retrospectively evaluated the data collection forms of 369 patients with CD from three Centers within the Sicilian Network. All the Centers used a standard data collection form. Results: A non-classical CD presentation was more frequent than the classical one, anemia being the most frequent symptom (50%). An I…