Non-gluten-free beer. Photo: CC--Phil Denton

Celiac.com 06/17/2016 - What role does individual sensitivity play in celiac disease severity and reactions to gluten?

Researchers in Italy reported on an interesting case of a of a man with a clear diagnosis of celiac disease who nevertheless drank gluten-containing beer, with no physical symptoms, and no clinical issues.

The research team included Fabiana Zingone, Ilaria Russo, Angelo Massari, and Carolina Ciacci. They are variously affiliated with the Department of Medicine and Surgery, and the Department of Clinical Pathology and Transfusion Medicine at AOU San Giovanni di Dio e Ruggi D'Aragona in Salerno, Italy.

The team found that a 4-week period of drinking gluten-containing beer did not provoke significant changes in the intestinal mucosa of this patient with celiac disease nor did it elicit any relevant symptoms. Blood antibody levels rose, but did not reach a pathological threshold.

It is of course possible that a longer gluten challenge might lead to symptoms and to clinically relevant changes in IgA antitransglutaminase levels. In this case, though, the patient seemed fine and showed no signs of an adverse celiac disease reaction, even though he drank standard non-gluten-free beer.

Celiac cases like this may be uncommon, but they do show that individual gluten sensitivity can impact symptoms, immunological response and intestinal mucosa health differently, depending on the patient. They also teach us how much more we have to learn about celiac disease.

Source: BMJ Case Reports 2016; doi:10.1136/bcr-2016-214686

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