Duodenal Histological Findings and Risk of Coeliac Disease in Subjects with Autoimmune Atrophic Gastritis: A Retrospective Evaluation

Zingone, Fabiana; Marsilio, Ilaria; Fassan, Matteo; Pilotto, V.; Maddalo, G.; Lorenzon, Greta; Savarino, Edoardo; Farinati, Fabio

doi:10.1159/000510354

Cited by 8 publications

(8 citation statements)

References 35 publications

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“…However, no link between reflux esophagitis or Barrett’s esophagus and CeD has been reported. Finally, autoimmune atrophic gastritis was previously modestly associated with CeD[ 26 ]. Our study, as well as other population-based studies and systematic reviews, did not confirm the association[ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Upper gastrointestinal endoscopic findings in celiac disease at diagnosis: A multicenter international retrospective study

Stefanolo¹,

Zingone²,

Gizzi³

et al. 2022

World J Gastroenterol

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BACKGROUND Gastroduodenal endoscopy and biopsy following positive specific serology is considered the gold standard to diagnose celiac disease (CeD) in adults. Whether upper endoscopy helps detect comorbid conditions is unknown. AIM To investigate the prevalence of non-celiac endoscopic findings in patients in whom endoscopy was performed to confirm CeD diagnosis. METHODS This is an observational, descriptive, multicenter, retrospective study that reports endoscopic findings obtained in adult patients enrolled in local registries from four tertiary centers. We collected data reported on first endoscopy, indicated for investigation of CeD. Diagnosis of CeD was performed by histology (≥ Marsh 2 type mucosal damage) and specific serology. Two European and one North American center included biopsy-confirmed CeD following positive serology. A fourth center (South America) included symptomatic patients undergoing endoscopy, irrespective of CeD serology. The latter cohort included a non-CeD control group. RESULTS A total of 1328 patients (80% female; 35 years median age) were enrolled, of whom 95.6% had positive specific serology. In 135 patients, endoscopy revealed 163 abnormalities unrelated to CeD (prevalence: 10.1%). Erosive reflux esophagitis (6.4%), gastric erosions (2.0%), and suspicion of esophageal metaplasia (1.2%) were the most common findings. Biopsy-confirmed Barrett’s esophagus was infrequent (0.2%). No endoscopic cancer was detected. Older patients (≥ 51 years of age) had a higher prevalence of endoscopic findings than those ≤ 50 ( P < 0.01). Within the South American cohort, CeD was associated with a lower rate (8.2%) of comorbid endoscopic findings compared with controls (29.1%; P < 0.001). In the adjusted multivariate analysis of this cohort, having CeD was associated with a 72% reduction in the risk of any endoscopic abnormality (P < 0.0001), and having alarm symptoms was associated with a 37% reduction in the risk of finding at least one endoscopic lesion ( P < 0.02). CONCLUSION In this large multicenter study, young adults with positive CeD serology had few comorbid endoscopic findings. Although patients over 51 years had a high prevalence of non-CeD gastroduodenal mucosal damage, no malignancy or premalignant lesions were found.

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Section: Discussionmentioning

confidence: 99%

Upper gastrointestinal endoscopic findings in celiac disease at diagnosis: A multicenter international retrospective study

Stefanolo¹,

Zingone²,

Gizzi³

et al. 2022

World J Gastroenterol

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“…Hepatic symptoms that may be related with celiac disease include asymptomatic increases in liver enzyme, steatosis, autoimmune liver disease and non-specific hepatitis [9][10] . One proposed pathogenesis mechanism, CLD in combination with CD, is reduced intestinal mucosal integrity, resulting in malabsorption and augmented permeability of mucosa, or liver toxin-mediated injury.…”

Section: Discussionmentioning

confidence: 99%

“…Although adult patients with coeliac disease first recorded abnormal liver function in the 1970s and have since shown that when they avoid gluten, their liver function improves, not every child has responded to a gluten-free diet, and much of the improvement in liver function was due to weight loss [7][8] . The range of liver entanglementvariesfrom liver injury to non-induced liver steatosis and isolated fibrosis to advanced liver disease counting cirrhosis, there are several different types of liver damage that can occur 9 . According to a PubMed search conducted between 2000 and 2017, histopathology research in CD is almost nonexistent.…”

Section: Introductionmentioning

confidence: 99%

Coeliac Disease and the Liver: Spectrum of Liver Serology, Histology and Response of Treatment with Gluten-Free Diet

Iqbal¹,

Anjum²,

Joher³

et al. 2021

PJMHS

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Aim: To evaluate the histological spectrum of "celiac hepatitis" and the likelihood that these features will return after GFD. Methods: The laboratory tests, Clinical profile, liver and duodenal biopsy were studied with the patients with hepatic derangement and CD among 35 patients. Whenever possible, a histological comparison of before and after GFD treatmenton liver and duodenal biopsies were performed. Results: In the records of the pathology and gastroenterology departments of our institute, CD and ECM were found in 35 patients. There were twenty-four men and 11 women with a mean age of 24.3 (10-50 range). Twenty-four patients were primarily identified with celiac disease and later diagnosed with CLD. At diagnosis, this feature was currently associated with small bowel diarrhea in 13 (65%) and CD without diarrhea in the remaining seven patients (35%). 10 of these 20 patients had anemia. Antibodies to TTG were positive in 21 patients (87.5%), AGA in 17 patients (70.8%), and EMA in 4 patients. Severe villous abnormality (Marsh-Oberhuber type 3C) in eleven patients (45.8.3%) on duodenal biopsy, moderate villous abnormality (type 3B) in seven patients (29.2%), 5 patients (20.8%) have mild abnormality of the villi (type 3A). The clinical topographies indicating the progress of liver ailment in these 24 cases are as follows: 8 have ascites (33.3%), 6(25%) patients have jaundice, hepatomegaly in 5 (20.8%) and 5(20.8%) Patients have splenomegaly. Conclusion: There has been a problematic case of coeliac disease that has undergone an unnoticed distinction. This is one of the few researches that shows the full range of Coeliac Disease liver histopathology, from non-invasive to invasive hepatitis’. Experiment of a GFD may outcome in clinicopathological enhancement of ’coeliac hepatitis’. Keywords: Gluten-free diet, coeliac disease, duodenal biopsies, hepatomegaly.

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“…These lesions are also characterised by an increase in the number of intraepithelial lymphocytes to above 25 lymphocytes per 100 enterocytes in structurally-correct small intestine mucosa. In the general population, lymphocytic duodenitis may affect 5.4% of the population [ 32 ], with lymphocytic duodenosis being identified in a range of infectious diseases of the gastrointestinal tract, especially autoimmune atrophic gastritis [ 33 ], Helicobacter pylori -related gastritis, AIDS enteropathy, Whipple’s disease, small intestinal bacterial overgrowth and post-viral enteropathy [ 32 ], as well as hypersensitivity to milk, soy, fish, eggs or other nutrients [ 2 ].…”

Section: Verification Of a Diagnosis Of Pcdmentioning

confidence: 99%

Wait-and-See Approach or Gluten-Free Diet Administration—The Rational Management of Potential Coeliac Disease

Szaflarska-Popławska

2021

Nutrients

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Potential celiac disease (PCD) is a heterogeneous disease; only some patients develop full celiac disease (CD), characterised by advanced atrophic changes in the small intestine. Few accurate prognostic factors exist for the progression of PCD; therefore, therapeutic decisions should be made on an individual basis in each case. Patients with clinical gastroenterological or parenteral symptoms often benefit from a gluten-free diet, and those left on a diet containing gluten should receive clinical, serological and histopathological supervision.

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Duodenal Histological Findings and Risk of Coeliac Disease in Subjects with Autoimmune Atrophic Gastritis: A Retrospective Evaluation

Cited by 8 publications

References 35 publications

Upper gastrointestinal endoscopic findings in celiac disease at diagnosis: A multicenter international retrospective study

Upper gastrointestinal endoscopic findings in celiac disease at diagnosis: A multicenter international retrospective study

Coeliac Disease and the Liver: Spectrum of Liver Serology, Histology and Response of Treatment with Gluten-Free Diet

Wait-and-See Approach or Gluten-Free Diet Administration—The Rational Management of Potential Coeliac Disease

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