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Small-bowel mucosal inflammation in reticulin or gliadin antibody-positive patients without villous atrophy.

Abstract：

BACKGROUND:We investigated whether individuals with positive coeliac disease antibodies but without small-bowel villous atrophy have mucosal inflammation implicating gluten-sensitivity. METHODS:Small-bowel mucosal morphology; CD3+, alphabeta+, and gammadelta+ T-cell receptor-bearing intraepithelial lymphocytes; and mucosal HLA-DR expression were studied in 96 IgA-class antireticulin or antigliadin antibody-positive adults suspected of having coeliac disease and in 27 control subjects. RESULTS:Villous atrophy compatible with coeliac disease was found in altogether 29 patients, in 18 of 21 (86%) patients with both antireticulin and antigliadin antibodies, in 9 of 15 (60%) patients with antireticulin antibodies only, and in 2 of 60 (3%) with antigliadin antibodies only. In 67 antibody-positive patients with normal villous architecture the densities of CD3+, alphabeta+, and gammadelta+ intraepithelial lymphocytes were significantly higher than in non-coeliac control subjects. Ten patients with initially increased densities of gammadelta+ T cells but normal villous structure underwent a follow-up biopsy after 4-18 months, which showed villous atrophy in five patients. CONCLUSIONS:IgA-class antireticulin or antigliadin antibody-positive patients with normal small-bowel mucosal morphology frequently have immunohistochemical markers of coeliac disease latency. Together with our follow-up data this implies that they may be gluten-sensitive.

journal_name

Scand J Gastroenterol

journal_title

Scandinavian journal of gastroenterology

authors

Kaukinen K,Collin P,Holm K,Karvonen AL,Pikkarainen P,Mäki M

doi

10.1080/003655298750026967

subject

Has Abstract

pub_date

1998-09-01 00:00:00

pages

944-9

issue

9

eissn

0036-5521

issn

1502-7708

journal_volume

33

pub_type

杂志文章

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