Identifying True Celiac Disease and Wheat Allergy in the Era of Fashion Driven Gluten-Free Diets.
Adolescent
Adult
Aged
Aged, 80 and over
Antibody Specificity
/ immunology
Biomarkers
Biopsy
Celiac Disease
/ diagnosis
Child
Child, Preschool
Comorbidity
Diagnosis, Differential
Diet, Gluten-Free
Female
GTP-Binding Proteins
/ immunology
Glutens
/ adverse effects
Humans
Immunoglobulin A
/ immunology
Immunoglobulin E
/ immunology
Infant
Longitudinal Studies
Male
Middle Aged
Protein Glutamine gamma Glutamyltransferase 2
ROC Curve
Transglutaminases
/ immunology
Wheat Hypersensitivity
/ diagnosis
Young Adult
Celiac disease
Specific IgE
Wheat allergy
Journal
International archives of allergy and immunology
ISSN: 1423-0097
Titre abrégé: Int Arch Allergy Immunol
Pays: Switzerland
ID NLM: 9211652
Informations de publication
Date de publication:
2019
2019
Historique:
received:
12
11
2018
accepted:
21
01
2019
pubmed:
22
3
2019
medline:
17
7
2019
entrez:
22
3
2019
Statut:
ppublish
Résumé
Diagnosing both celiac disease (CD) and wheat allergy (WA) might be challenging due to the increasingly popular gluten-free diets. 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. Serological markers of autoimmunity and allergy along with medical charts of patients assessed for tTGIgA and WIgE between 2010 and 2016 were evaluated. 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. 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.
Sections du résumé
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.
Identifiants
pubmed: 30897589
pii: 000497115
doi: 10.1159/000497115
doi:
Substances chimiques
Biomarkers
0
Immunoglobulin A
0
Immunoglobulin E
37341-29-0
Glutens
8002-80-0
Protein Glutamine gamma Glutamyltransferase 2
EC 2.3.2.13
Transglutaminases
EC 2.3.2.13
GTP-Binding Proteins
EC 3.6.1.-
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
132-141Informations de copyright
© 2019 S. Karger AG, Basel.