No popular authors found.
Ads by Google:

Categories

No categories found.


Get Celiac.com's E-Newsletter




Ads by Google:


Questions? Join Our Forum:
~1 Million Posts
& Over 66,000 Members!



SHARE THIS PAGE:
Celiac.com Sponsors:

Predictors for Celiac Disease in Adult Cases of Duodenal Intraepithelial Lymphocytosis

Celiac.com 09/15/2014 - Duodenal intraepithelial lymphocytosis (D-IEL) is an early marker for celiac disease, even though a majority of cases are due to non-celiac disease conditions.

Photo: Wikimedia Commons--Eva K.Researchers I. Aziz, T. Key, J.G. Goodwin, and D.S. Sanders wanted to identify the predictors of celiac disease in patients presenting with D-IEL. For their study, they reviewed 215 adults with D-IEL who had undergone prospective and systematic evaluation for celiac disease and other recognized associations. They confirmed celiac disease based on presence of HLA-DQ2 and/or DQ8, persistence or progression of D-IEL following a gluten challenge, and an improvement in symptoms with a gluten-free diet.

To compare factors in celiac and non-celiac cases, and to determine their sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), the team used binary logistic regression models, adjusted for age and sex. They diagnosed celiac disease in 48 cases (22%) and non-celiac in 167 cases (78%). They found no statistical difference between the celiac and non-celiac group in terms of baseline demographics, anemia, hematinics, or clinical symptoms, such as diarrhea, weight loss, abdominal pain.

Compared with their non-celiac counterparts, celiac patients were significantly more likely to have a positive family history of celiac disease (21% vs. 3.6%, OR 6.73; PPV 62.5%, NPV 81%, specificity 96.4%), positive HLA-DQ status (100% vs. 49.1%; PPV 36.4%, NPV 100%, specificity 50.9%), and presence of endomysial antibody (EMA) (48% vs. 0%; PPV 100%, NPV 87%, specificity 100%); all P≤0.001.

Ads by Google:

A total of 29.2% celiac and 83.2% non-celiac cases showed normal tissue transglutaminase antibody (TTG) levels (OR 0.084, P<0.001; PPV 9.2%).

Between the groups, there was no difference in the prevalence of TTG levels 1 to 2×upper limit of normal (29.2% celiac vs. 14.4% non-celiac; PPV 33% to 38%). However, TTG levels between 3 and 20×ULN were much more common in the celiac group (33.3% vs. 2.4%, PPV 66.6% to 89%), whereas a TTG>20×ULN was exclusive to celiac disease (8.3%, P<0.001, PPV 100%).

For patients with D-IEL, only a positive EMA or TTG greater than 20×ULN at the outset can yield an immediate celiac diagnosis. On their own, factors such as gastrointestinal symptoms, family history, anemia, or other celiac serology results do not reliably distinguish celiac from non-celiac patients.

Source:

Celiac.com welcomes your comments below (registration is NOT required).












Related Articles



Comments




Rate this article and leave a comment:
Rating: * Poor Excellent
Your Name *: Email (private) *:




In Celiac.com's Forum Now:


Thank you! I have been considering lactose, though I'm reluctant to remove more things from her diet. She has not had the classic lactose intolerance symptoms of diarrhea, gas, or bloating, though I know she could still have trouble with it. She's been on the medication for less than a week,...

cyclinglady, I think Joseph is hoping to exclude celiac disease. I feel for him, as I also had a hard time accepting my daughter's celiac. I had this gene test done hoping our GI doctor made a terrible mistake. But now I have triple prove that my daughter really does have it! I agre...

Our doctor ordered the Prometheus Celiac Plus test for us. It is some sort of in depth celiac blood test. This test report showed which celiac gene my daughter has. I think you can ask your GI for a celiac blood test with EMA. When I asked for the EMA test, we got this Celiac plus r...

Why? Some 35% of the population carries the genes that could develop into celiac disease. But only a few actually develop it. It is used to exclude celiac disease and not to diagnose it. There are some outlier genes too that have been discovered recently, so the gene test is not perfect. ...

It will turn around, but it probably is going to take more time. Yes, adhering to the gluten-free diet is critical, but what doctors fail to tell you is that is can take time for antibodies to decrease. For some it is a few weeks and for others months to years. It sounds like you are do...