• Join our community!

    Do you have questions about celiac disease or the gluten-free diet?

  • Ads by Google:
     




    Get email alerts Subscribe to Celiac.com's FREE weekly eNewsletter

    Ads by Google:



       Get email alertsSubscribe to Celiac.com's FREE weekly eNewsletter

  • Member Statistics

    77,471
    Total Members
    3,093
    Most Online
    Rakhi
    Newest Member
    Rakhi
    Joined
  • 0

    Gluten-Free Challah (Dairy-Free Option)


    Jules Shepard

    Although associated with important Jewish holidays like Rosh Hashanah (the Jewish New Year), challah is not only a culturally significant bread at these times of year, but also a delicious and impressive bread to serve at your table any time.


    Ads by Google:




    ARTICLE CONTINUES BELOW ADS
    Ads by Google:



    No matter what your reason for making this delicious bread, celebrate that this quick, easy (yes, I said easy!) and very impressive recipe is at your gluten-free fingertips any time you feel like looking forward to a sweeter day.

    All of you who have seen me at gluten-free cooking classes or demonstrations making yeast breads already know the dirty little secret about gluten-free bread. Shhhh.... don't tell the gluten-eaters! Seriously! It is super quick and shockingly easy to make homemade gluten-free bread! Impress your friends and shock the neighbors with this recipe too: not only is gluten-free challah delicious and super fast, it's almost too beautiful to eat!

    Gluten-Free ChallahIngredients:
    1/3 cup warm water
    1 package rapid rise gluten-free yeast
    1 tsp. granulated cane sugar
    1 cup vanilla dairy or non-dairy (soy or coconut yogurt) at room temperature
    1 tsp. apple cider vinegar
    5 large egg yolks at room temperature (slightly mixed)
    1/3 cup canola oil
    4 Tbs. honey, agave nectar or molasses
    4 cups Jules Gluten Free All Purpose Flour*
    3 Tbs. + 2 tsp. granulated cane sugar
    1 ¼ tsp. kosher salt
    ½ tsp. baking soda
    2 tsp. gluten-free baking powder
    1 large egg, mixed
    Poppy seeds, sesame seeds, raisins, or other topping or mix-in (optional)

    Directions:
    Preheat your oven to 200 F, then turn it off; if you have a warming drawer, you may set that to low/moist setting instead. Prepare a baking sheet by lining it with parchment paper.

    Bread Machine Method:
    Pour all the liquid ingredients into a bread machine set to "Dough" setting. Next add the sugar and honey and then the remaining dry ingredients, save the yeast. Make a well in the top of the dry ingredients and pour the yeast into the center. Close the lid and start the dough cycle. (If you choose to add raisins to the batter, add them during this cycle, after all the other ingredients have been mixed together). Watch to see that the dry ingredients are fully integrated; if they are not completely mixing in, go around the inside of the pan with a rubber spatula to aid in the mixing process. When the mixing portion of the cycle ends, you may remove the dough (don't wait for the gluten “dough” cycle to finish, as it will let the dough sit for 1 or 2 hours after mixing – this is not what you want for this gluten-free dough!).

    Stand Mixer Method:
    In a small bowl, mix together the warm water, yeast and 1 teaspoon of sugar to proof the yeast; set aside. In the bowl of your stand mixer, add the remaining wet ingredients and mix until combined. Whisk together the dry ingredients in a separate bowl. After 5 minutes of proofing, stir in the yeast-water mixture into the wet ingredients (note: if your yeast isn't bubbling at this point, throw it out and start again with fresh yeast). Gradually stir in the dry ingredients until fully integrated, then mix 2 minutes more on medium speed.

    Using either method, once the dough is combined, divide it in half and divide each half into three equally-sized balls. Roll each ball out into a coil or long log on a clean, flat surface dusted lightly with Jules Gluten Free™ All Purpose Flour. Pinch together one end of each coil, wetting them slightly with water to help them join together at the top, then braid them, finishing by connecting them to the top of the other end in order to form a crown, or circular shape. You will then have one round challah loaf. Gently transfer it to the parchment-lined baking sheet. Repeat for the second set of three balls. In the alternative, you can simply divide the dough in half, roll out into a flattened coil, then twist upon itself and join at the ends to form a circular loaf; repeat with the other half of the dough ball.

    In a small bowl, mix the extra egg together and brush over each loaf well, coating the entire top surface. Sprinkle the seeds or any toppings at this point, then place the tray (covering the loaves with wax paper sprayed with cooking oil) in a warming drawer set to low heat, or into the preheated oven for approximately 20 - 30 minutes. (Don't expect the bread to rise much at this stage).

    Once risen slightly, place the uncovered tray in an oven preheated to 350 F (static) or 325 F (convection) for 20-25 minutes. Remove to cool on a wire rack and cut after slightly cooled.

    0


    User Feedback

    Recommended Comments

    Guest cka1923

    Posted

    Wow, so glad I can still have great Challah! Awesome recipe.

    Share this comment


    Link to comment
    Share on other sites
    Guest Lindsey

    Posted

    I would REALLY like to make this, but have an egg allergy. Would you suggest a substitute or would it not turn out? Thank you so much!

    Share this comment


    Link to comment
    Share on other sites

    I'd also like to know about the egg replacement, please.

    Share this comment


    Link to comment
    Share on other sites
    Guest Marilyn

    Posted

    I too would like to know about the egg replacement... does it work?

    Share this comment


    Link to comment
    Share on other sites

    Need a recipe with over 55% oat flour for truly Kosher recipe as oats are the only Biblical grain that is truly gluten free.

    Share this comment


    Link to comment
    Share on other sites


    Your content will need to be approved by a moderator

    Guest
    You are commenting as a guest. If you have an account, please sign in.
    Add a comment...

    ×   Pasted as rich text.   Paste as plain text instead

      Only 75 emoji are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.


  • Popular Contributors

  • Ads by Google:

  • Who's Online   4 Members, 0 Anonymous, 312 Guests (See full list)

  • Related Articles

    Scott Adams
    This recipe comes to us from Aviva Mandl (Enjoy and have a good Pesach!).
    2 carrots
    2 stalks of celery
    1 small or medium onion
    2 eggs
    ¼ cup of oil
    1 six-ounce box of Manischewitz Potato Pancake Mix
    Grind onion, carrots and celery in a food processor. Put into a large mixing bowl. Add the box of potato pancake mix, eggs and oil. Mix well and spoon onto foil to form two to three rolls, approximately 2 inches in diameter by 8 inches long. Wrap and pinch the ends of the foil closed. Bake at 350 degrees F for 1 hour. Remove from the oven and let stand about 10 minutes. Unwrap foil and slice into pieces to serve.
    I typically have added salt and pepper to this recipe, however since the potato pancake mix is seasoned, I opted not to do so. I recommend doubling or tripling the recipe and freezing kishkes for another meal (I doubled the recipe when I made it tonight and wound up with two really nice-sized rolls and 2 small ones). If freezing, you dont need to bake it first. Ive found my family likes this recipe more than any of the store-bought kishkes.

    Scott Adams
    This recipe comes to us from Julie Bort.
    Ingredients:
    ½ cup brown rice flour
    ½ cup tapioca flour
    ½ cup cornstarch
    ½ Tablespoon potato flour (not starch)
    2 Tablespoons Cream of Buckwheat cereal
    ¼ teaspoon xanthan gum
    ½ teaspoon gelatin (can be Kosher)
    2 eggs
    1 teaspoon salt
    2 Tablespoons oil
    2 Tablespoons chicken soup stock
    Directions:
    Mix ingredients together. Refrigerate at least a ½ hour. Drop by heaping tablespoons into boiling, salted water. Cook in a wide, covered pot, 35 minutes (Note: they will cook up as free-form shapes and wont be round. They are too soft to roll.). If they stick to the bottom, gently pry them off after the first five minutes. These are delicate and some crumbling will occur in the boiling water. Do not stir or prod them too much. Also, take them out of the boiling water as soon as they are soft enough for your taste. Letting them soak will cause them to crumble too much. They freeze ok (if you have any left to freeze!).
    Makes about 12.

    Scott Adams
    Ingredients:
    4 tablespoons rendered chicken fat (*you can use plain oil, but its not nearly as good. I use Empire Kosher rendered chicken fat – pre-frozen in tubs)
    4 eggs
    1 teaspoon salt
    ½ cup gluten-free flour
    ¾ cup dried potato flakes
    Directions:
    Blend eggs and chicken fat (with fork, or with Cuisinart). Add dry ingredients, and mix. Cover and let sit in fridge for at least 30 minutes. Have briskly boiling water ready. Roll 1 ½ inch balls from mixture using wet hands, drop into boiling water. When all balls are in water, use a long spoon to make sure none of the balls are stuck to the bottom of the pot. Cover pot with lid, and cook over medium heat for 35 minutes. Using slotted spoon, transfer balls directly to soup, or to freeze for later use, transfer to waxpaper lined cookie sheet and freeze until hard, then transfer into zip lock freezer bags. Makes about 11 matzo balls. Recipe can be easily doubled or halved.


    Scott Adams
    This recipe comes to us from "debmidge" in the Gluten-Free Forum.

    Ingredients:
    1 stick butter or margerine
    1 cup sugar
    1 egg
    2 tablespoons orange juice (or lemon juice)
    1 teaspoon vanilla
    2 teaspoons baking powder
    ¾ teaspoon xanthan gum
    ¾ cup corn starch *
    ½ cup white rice flour *
    ½ cup brown rice flour *
    ½ cup potato starch *
    ¼ cup tapioca flour *

    *or use 2 ½ cups gluten-free flour of your choice

    Filling: Apricot, prune, or strawberry preserves or jam mini chocolate chips, M&Ms, etc.

    Directions:

    In mixer, cream butter and sugar. Add egg. Add orange juice and vanilla. In separate bowl, combine flour, baking powder and xanthan. Add flour slowly to mixture. Refrigerate dough for several hours ( I do overnight). Roll out dough onto lightly gluten-free floured surface. Roll to 1/8 to ¼ inch thickness. Cut into circles with 2 ½ inch wide glass. Fill each circle with about ½ teaspoonful of filling of your choice. Fold up 3 sides of circle and pinch edges firmly to form triangle with opening at center to let filling peek through. Bakeat 375F degrees on parchment covered cookie sheet for about 15 minutes,or until lightly browned. Let cool before transferring to plate.
    This recipe makes about 26 gluten-free Hamantaschen cookies, and it can be doubled.


  • Recent Articles

    Jefferson Adams
    Celiac.com 06/19/2018 - Could baking soda help reduce the inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease? Scientists at the Medical College of Georgia at Augusta University say that a daily dose of baking soda may in fact help reduce inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease.
    Those scientists recently gathered some of the first evidence to show that cheap, over-the-counter antacids can prompt the spleen to promote an anti-inflammatory environment that could be helpful in combating inflammatory disease.
    A type of cell called mesothelial cells line our body cavities, like the digestive tract. They have little fingers, called microvilli, that sense the environment, and warn the organs they cover that there is an invader and an immune response is needed.
    The team’s data shows that when rats or healthy people drink a solution of baking soda, the stomach makes more acid, which causes mesothelial cells on the outside of the spleen to tell the spleen to go easy on the immune response.  "It's most likely a hamburger not a bacterial infection," is basically the message, says Dr. Paul O'Connor, renal physiologist in the MCG Department of Physiology at Augusta University and the study's corresponding author.
    That message, which is transmitted with help from a chemical messenger called acetylcholine, seems to encourage the gut to shift against inflammation, say the scientists.
    In patients who drank water with baking soda for two weeks, immune cells called macrophages, shifted from primarily those that promote inflammation, called M1, to those that reduce it, called M2. "The shift from inflammatory to an anti-inflammatory profile is happening everywhere," O'Connor says. "We saw it in the kidneys, we saw it in the spleen, now we see it in the peripheral blood."
    O'Connor hopes drinking baking soda can one day produce similar results for people with autoimmune disease. "You are not really turning anything off or on, you are just pushing it toward one side by giving an anti-inflammatory stimulus," he says, in this case, away from harmful inflammation. "It's potentially a really safe way to treat inflammatory disease."
    The research was funded by the National Institutes of Health.
    Read more at: Sciencedaily.com

    Jefferson Adams
    Celiac.com 06/18/2018 - Celiac disease has been mainly associated with Caucasian populations in Northern Europe, and their descendants in other countries, but new scientific evidence is beginning to challenge that view. Still, the exact global prevalence of celiac disease remains unknown.  To get better data on that issue, a team of researchers recently conducted a comprehensive review and meta-analysis to get a reasonably accurate estimate the global prevalence of celiac disease. 
    The research team included P Singh, A Arora, TA Strand, DA Leffler, C Catassi, PH Green, CP Kelly, V Ahuja, and GK Makharia. They are variously affiliated with the Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Lady Hardinge Medical College, New Delhi, India; Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway; Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Gastroenterology Research and Development, Takeda Pharmaceuticals Inc, Cambridge, MA; Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy; Department of Medicine, Columbia University Medical Center, New York, New York; USA Celiac Disease Center, Columbia University Medical Center, New York, New York; and the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
    For their review, the team searched Medline, PubMed, and EMBASE for the keywords ‘celiac disease,’ ‘celiac,’ ‘tissue transglutaminase antibody,’ ‘anti-endomysium antibody,’ ‘endomysial antibody,’ and ‘prevalence’ for studies published from January 1991 through March 2016. 
    The team cross-referenced each article with the words ‘Asia,’ ‘Europe,’ ‘Africa,’ ‘South America,’ ‘North America,’ and ‘Australia.’ They defined celiac diagnosis based on European Society of Pediatric Gastroenterology, Hepatology, and Nutrition guidelines. The team used 96 articles of 3,843 articles in their final analysis.
    Overall global prevalence of celiac disease was 1.4% in 275,818 individuals, based on positive blood tests for anti-tissue transglutaminase and/or anti-endomysial antibodies. The pooled global prevalence of biopsy-confirmed celiac disease was 0.7% in 138,792 individuals. That means that numerous people with celiac disease potentially remain undiagnosed.
    Rates of celiac disease were 0.4% in South America, 0.5% in Africa and North America, 0.6% in Asia, and 0.8% in Europe and Oceania; the prevalence was 0.6% in female vs 0.4% males. Celiac disease was significantly more common in children than adults.
    This systematic review and meta-analysis showed celiac disease to be reported worldwide. Blood test data shows celiac disease rate of 1.4%, while biopsy data shows 0.7%. The prevalence of celiac disease varies with sex, age, and location. 
    This review demonstrates a need for more comprehensive population-based studies of celiac disease in numerous countries.  The 1.4% rate indicates that there are 91.2 million people worldwide with celiac disease, and 3.9 million are in the U.S.A.
    Source:
    Clin Gastroenterol Hepatol. 2018 Jun;16(6):823-836.e2. doi: 10.1016/j.cgh.2017.06.037.

    Jefferson Adams
    Celiac.com 06/16/2018 - Summer is the time for chips and salsa. This fresh salsa recipe relies on cabbage, yes, cabbage, as a secret ingredient. The cabbage brings a delicious flavor and helps the salsa hold together nicely for scooping with your favorite chips. The result is a fresh, tasty salsa that goes great with guacamole.
    Ingredients:
    3 cups ripe fresh tomatoes, diced 1 cup shredded green cabbage ½ cup diced yellow onion ¼ cup chopped fresh cilantro 1 jalapeno, seeded 1 Serrano pepper, seeded 2 tablespoons lemon juice 2 tablespoons red wine vinegar 2 garlic cloves, minced salt to taste black pepper, to taste Directions:
    Purée all ingredients together in a blender.
    Cover and refrigerate for at least 1 hour. 
    Adjust seasoning with salt and pepper, as desired. 
    Serve is a bowl with tortilla chips and guacamole.

    Dr. Ron Hoggan, Ed.D.
    Celiac.com 06/15/2018 - There seems to be widespread agreement in the published medical research reports that stuttering is driven by abnormalities in the brain. Sometimes these are the result of brain injuries resulting from a stroke. Other types of brain injuries can also result in stuttering. Patients with Parkinson’s disease who were treated with stimulation of the subthalamic nucleus, an area of the brain that regulates some motor functions, experienced a return or worsening of stuttering that improved when the stimulation was turned off (1). Similarly, stroke has also been reported in association with acquired stuttering (2). While there are some reports of psychological mechanisms underlying stuttering, a majority of reports seem to favor altered brain morphology and/or function as the root of stuttering (3). Reports of structural differences between the brain hemispheres that are absent in those who do not stutter are also common (4). About 5% of children stutter, beginning sometime around age 3, during the phase of speech acquisition. However, about 75% of these cases resolve without intervention, before reaching their teens (5). Some cases of aphasia, a loss of speech production or understanding, have been reported in association with damage or changes to one or more of the language centers of the brain (6). Stuttering may sometimes arise from changes or damage to these same language centers (7). Thus, many stutterers have abnormalities in the same regions of the brain similar to those seen in aphasia.
    So how, you may ask, is all this related to gluten? As a starting point, one report from the medical literature identifies a patient who developed aphasia after admission for severe diarrhea. By the time celiac disease was diagnosed, he had completely lost his faculty of speech. However, his speech and normal bowel function gradually returned after beginning a gluten free diet (8). This finding was so controversial at the time of publication (1988) that the authors chose to remain anonymous. Nonetheless, it is a valuable clue that suggests gluten as a factor in compromised speech production. At about the same time (late 1980’s) reports of connections between untreated celiac disease and seizures/epilepsy were emerging in the medical literature (9).
    With the advent of the Internet a whole new field of anecdotal information was emerging, connecting a variety of neurological symptoms to celiac disease. While many medical practitioners and researchers were casting aspersions on these assertions, a select few chose to explore such claims using scientific research designs and methods. While connections between stuttering and gluten consumption seem to have been overlooked by the medical research community, there is a rich literature on the Internet that cries out for more structured investigation of this connection. Conversely, perhaps a publication bias of the peer review process excludes work that explores this connection.
    Whatever the reason that stuttering has not been reported in the medical literature in association with gluten ingestion, a number of personal disclosures and comments suggesting a connection between gluten and stuttering can be found on the Internet. Abid Hussain, in an article about food allergy and stuttering said: “The most common food allergy prevalent in stutterers is that of gluten which has been found to aggravate the stutter” (10). Similarly, Craig Forsythe posted an article that includes five cases of self-reporting individuals who believe that their stuttering is or was connected to gluten, one of whom also experiences stuttering from foods containing yeast (11). The same site contains one report of a stutterer who has had no relief despite following a gluten free diet for 20 years (11). Another stutterer, Jay88, reports the complete disappearance of her/his stammer on a gluten free diet (12). Doubtless there are many more such anecdotes to be found on the Internet* but we have to question them, exercising more skepticism than we might when reading similar claims in a peer reviewed scientific or medical journal.
    There are many reports in such journals connecting brain and neurological ailments with gluten, so it is not much of a stretch, on that basis alone, to suspect that stuttering may be a symptom of the gluten syndrome. Rodney Ford has even characterized celiac disease as an ailment that may begin through gluten-induced neurological damage (13) and Marios Hadjivassiliou and his group of neurologists and neurological investigators have devoted considerable time and effort to research that reveals gluten as an important factor in a majority of neurological diseases of unknown origin (14) which, as I have pointed out previously, includes most neurological ailments.
    My own experience with stuttering is limited. I stuttered as a child when I became nervous, upset, or self-conscious. Although I have been gluten free for many years, I haven’t noticed any impact on my inclination to stutter when upset. I don’t know if they are related, but I have also had challenges with speaking when distressed and I have noticed a substantial improvement in this area since removing gluten from my diet. Nonetheless, I have long wondered if there is a connection between gluten consumption and stuttering. Having done the research for this article, I would now encourage stutterers to try a gluten free diet for six months to see if it will reduce or eliminate their stutter. Meanwhile, I hope that some investigator out there will research this matter, publish her findings, and start the ball rolling toward getting some definitive answers to this question.
    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

    Jefferson Adams
    Celiac.com 06/14/2018 - Refractory celiac disease type II (RCDII) is a rare complication of celiac disease that has high death rates. To diagnose RCDII, doctors identify a clonal population of phenotypically aberrant intraepithelial lymphocytes (IELs). 
    However, researchers really don’t have much data regarding the frequency and significance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. Such data could provide useful comparison information for patients with RCDII, among other things.
    To that end, a research team recently set out to try to get some information about the frequency and importance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. The research team included Shafinaz Hussein, Tatyana Gindin, Stephen M Lagana, Carolina Arguelles-Grande, Suneeta Krishnareddy, Bachir Alobeid, Suzanne K Lewis, Mahesh M Mansukhani, Peter H R Green, and Govind Bhagat.
    They are variously affiliated with the Department of Pathology and Cell Biology, and the Department of Medicine at the Celiac Disease Center, New York Presbyterian Hospital/Columbia University Medical Center, New York, USA. Their team analyzed results of TCR-GR analyses performed on SB biopsies at our institution over a 3-year period, which were obtained from eight active celiac disease, 172 celiac disease on gluten-free diet, 33 RCDI, and three RCDII patients and 14 patients without celiac disease. 
    Clonal TCR-GRs are not infrequent in cases lacking features of RCDII, while PCPs are frequent in all disease phases. TCR-GR results should be assessed in conjunction with immunophenotypic, histological and clinical findings for appropriate diagnosis and classification of RCD.
    The team divided the TCR-GR patterns into clonal, polyclonal and prominent clonal peaks (PCPs), and correlated these patterns with clinical and pathological features. In all, they detected clonal TCR-GR products in biopsies from 67% of patients with RCDII, 17% of patients with RCDI and 6% of patients with gluten-free diet. They found PCPs in all disease phases, but saw no significant difference in the TCR-GR patterns between the non-RCDII disease categories (p=0.39). 
    They also noted a higher frequency of surface CD3(−) IELs in cases with clonal TCR-GR, but the PCP pattern showed no associations with any clinical or pathological feature. 
    Repeat biopsy showed that the clonal or PCP pattern persisted for up to 2 years with no evidence of RCDII. The study indicates that better understanding of clonal T cell receptor gene rearrangements may help researchers improve refractory celiac diagnosis. 
    Source:
    Journal of Clinical Pathologyhttp://dx.doi.org/10.1136/jclinpath-2018-205023