Celiac.com 08/24/2016 - Although serological tests are useful for identifying celiac disease, it is well known that a small minority of celiacs are seronegative, and show no blood markers for celiac disease. A team of researchers wanted to define the prevalence and features of seronegative compared to seropositive celiac disease, and to establish whether celiac disease is a common cause of seronegative villous atrophy.
The research team included U Volta, G Caio, E Boschetti, F Giancola, KJ Rhoden, E Ruggeri, P Paterini, and R De Giorgio. They are all affiliated with the Department of Medical and Surgical Sciences, University of Bologna, St. Orsola-Malpighi Hospital, Italy. They looked at clinical, histological and laboratory findings from 810 celiac disease diagnoses, and retrospectively characterized seronegative patients.
The most common diagnosis in the 31 cases with seronegative flat mucosa was celiac disease at 45%, along with Giardiasis at 20%, common variable immunodeficiency at 16%, and autoimmune enteropathy at 10%.
Although rare, seronegative celiac disease is the most common cause of seronegative villous atrophy with a high median age at diagnosis; a close association with malabsorption and flat mucosa; and a high prevalence of autoimmune disorders.
Physicians treating seronegative villous atrophy should consider seronegative celiac disease as a possibility.