No popular authors found.


Get Celiac.com's E-Newsletter

Categories

No categories found.







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:


Sure, you should consider getting tested for celiac disease. There is no test for Non-Celiac Gluten Intolerance or Sensivity. However, you have to be consuming gluten daily for at least 12 weeks as ALL celiac tests require you to be consuming gluten. Learn more about testing: http:/...

Welcome Isabel! It is hard having celiac disease, but after a while it does get easier. Just so you know, I am an adult, but I am a Girl Scout Leader, have a daughter who is 16 and one of my daughter?s friends was just diagnosed with celiac disease just three weeks ago! Social...

I have two suggestions. First try switching to mostly natural gluten free foods. It makes the diet much easier. Second, i know you said you know the consequences, but really think deeply. in some ways, gluten is poison to your intestines. it literally eats away at it! so next time you think about...

I?m in middle school and here is my story of celiacs. i was short all my life and had mild stomach aches. Finally, about a year and a half ago, my doctors realized it was celiacs. The blood tests came back positive for it, so i got the endoscopy. sure enough, i had celiacs. it is so hard for me f...

Hey I?m around the same age! I get it and feel the same way. I was diagnosed only over a year ago and my celiacs very hard to deal with at social events. But what ever you do, don?t cheat the diet! The consequences will come back. I?m here to chat if anyone needs support