The Oslo definitions for coeliac disease and related terms

Ludvigsson, Jonas F.; Leffler, Daniel A.; Bai, Julio C.; Biagi, Federico; Fasano, Alessio; Green, Peter H. R.; Hadjivassiliou, Marios; Kaukinen, Katri; Kelly, Ciarán P.; Leonard, J.N.; Lundin, Knut E.A.; Murray, Joseph A.; Sanders, David S.; Walker, Marjorie M.; Zingone, Fabiana; Ciacci, Carolina

doi:10.1136/gutjnl-2011-301346

Cited by 1,425 publications

(1,364 citation statements)

References 209 publications

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“…Celiac Disease (CD) is an autoimmune disorder characterized by a chronic intestinal inflammatory response due to the ingestion of gluten, leading to some degree of villous atrophy and potential nutrient malabsorption (14) . Its diagnosis is based on the presence of histological signs of villous atrophy with increased intraepithelial lymphocites on duodenal biopsies and positive antibodies against specific targets, mainly tissue-transglutaminase, gliadin or endomysium (8) .…”

Section: Introductionmentioning

confidence: 99%

Celiac disease prevalence is not increased in patients with functional dyspepsia

Lasa¹,

Spallone²,

Gandara³

et al. 2017

Arq. Gastroenterol.

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-Background -Previous evidence trying to assess the risk of celiac disease among dyspeptic patients has been inconclusive, showing in some cases notorious discrepancies. Objective -To determine the prevalence of celiac disease in patients with dyspepsia compared to healthy controls without dyspepsia. Methods -Adult patients under evaluation for dyspepsia were invited to participate. These patients were offered an upper gastrointestinal endoscopy with duodenal biopsies. On the other hand, asymptomatic adult volunteers who performed a preventive visit to their primary care physician were invited to participate and agreed to undertake an upper gastrointestinal endoscopy with duodenal biopsies as well. Those patients with histologic signs of villous atrophy were furtherly evaluated and serological tests were performed in order to determine celiac disease diagnosis. Celiac disease prevalence was compared between groups. Results -Overall, 320 patients with dyspepsia and 320 healthy controls were recruited. There were no significant differences in terms of gender or age between groups. Celiac disease diagnosis was made in 1.25% (4/320) of patients in the dyspepsia group versus 0.62% (2/320) in the control group. Conclusion -Patients with dyspepsia who underwent routine duodenal biopsies did not show an increased risk for celiac disease when compared to healthy individuals. HEADINGS -Celiac disease. Dyspepsia. Endoscopy.

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Section: Introductionmentioning

confidence: 99%

Celiac disease prevalence is not increased in patients with functional dyspepsia

Lasa¹,

Spallone²,

Gandara³

et al. 2017

Arq. Gastroenterol.

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“…Patients with serum positivity for anti-TG2 and normal duodenal mucosa, or with slight signs of inflammation, are defined today as potential coeliac patients [2,9]. In this group of patients intestinal deposits of IgA anti-TG2 are found less often [8,10].…”

Section: Introductionmentioning

confidence: 99%

Intestinal anti-tissue transglutaminase antibodies in potential coeliac disease

Tosco

Aitoro

Auricchio

et al. 2012

Clinical and Experimental Immunology

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SummaryAnti-tissue transglutaminase 2 (anti-TG2) antibodies are present in the serum of the great majority of untreated coeliac disease (CD) patients. They are produced and deposited in the small intestinal mucosa. Potential CD patients present serum anti-TG2 antibodies higher than cut-off, but a normal duodenal mucosa where mucosal deposits of anti-TG2 are not always detectable. The aim of our work was to investigate the presence of anti-TG2 intestinal antibodies in patients with potential CD, and identify the most sensitive test to detect them. Twelve active CD patients, 28 potential CD patients and 39 non-CD controls were enrolled. Biopsy fragments from all patients were analysed by double immunofluorescence to detect mucosal deposits of anti-TG2 antibodies. Fragments from the same subjects were also cultured for 24 h with medium in the presence or absence of gliadin peptides. Anti-TG2 autoantibodies secreted into supernatants were measured by enzyme-linked immunosorbent assay. All active CD, 68% of potential CD patients and 20% of non-CD controls showed mucosal deposits of immunoglobulin (Ig)A anti-TG2; at the same time 100, 96 and 8% of active CD, potential CD and non-CD control patients secreted these antibodies in culture supernatants, respectively. Our data showed that, to detect intestinal anti-TG2 antibodies, the measurement of antibodies secreted into culture supernatants has higher sensitivity and specificity (97·5 and 92·3%, respectively) than the detection of mucosal deposits (77·5 and 80·0%, respectively). The measurement of intestinal anti-TG2 antibodies may prove useful in clinical practice to predict evolution towards mucosal atrophy in potential coeliac patients and identify patients with gluten sensitivity.

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“…The combination of inflammation and malabsorption manifests as the typical gastrointestinal symptoms of diarrhea and abdominal pain. A number of extra-intestinal manifestations of this disease have also been identified, including osteopenia, anemia, neurological symptoms, infertility, dermatitis herpetiformis, and menstrual irregularities [1].…”

Section: Introductionmentioning

confidence: 99%

A Remarkable Increase in Bone Mineral Density in Celiac Disease

Szczepanczyk¹,

Saberinia²,

Mirza³

2017

IJCD

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Introduction: Patients with active celiac disease are more likely to have osteoporosis and increased risk of fractures. Studies show that gluten-free diet may help improve bone mass to some extent. Here, we report a premenopausal woman with celiac disease with progressively declining bone mineral density (BMD) into severe osteoporosis range, who demonstrated a remarkable improvement in BMD after one year of gluten-free diet and oral bisphosphonates. Clinical case: A 44-year old premenopausal female had a low screening bone density at the ankle at 39 years of age, and was confirmed to have low BMD by central DXA, with osteoporosis at the spine and osteopenia at the hips. Celiac antibodies were positive and she was recommended gluten free diet (GFD), which she stopped after a year. Her primary care also started her on supplemental calcium and vitamin D with stabilization of BMD over the next three years. Subsequent BMD 2 years later showed 7.6% decrease in bone density at the lumbar spine (T-score -3) and 5.8% decline at the total hip (T-score -2.7) and she was referred for osteoporosis evaluation. Workup revealed high bone turnover with an elevated PTH of 162pg/mL, low normal serum calcium of 8.8mg/dL, normal vitamin D levels and low urine calcium levels, suggestive of secondary hyperparathyroidism. At this time, review of systems revealed a questionable history of gluten sensitivity, but she denied any diarrhea or bloating. A duodenal biopsy revealed villous atrophy and positive antibodies against tissue transglutaminase, compatible with active celiac disease. She was started on a gluten-free diet and alendronate was also added in view of low bone density and high bone resorption. Bone density performed one year later revealed a remarkable 14.1% increase at the level of the lumbar spine and 8.9% increase at the level of total hip compared to prior BMD. Conclusion: This is the first case of such a remarkable increase in BMD on gluten-free diet and concomitant bisphosphonate use, suggesting a cumulative benefit of this strategy that is greater than using either of these interventions alone.

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The Oslo definitions for coeliac disease and related terms

Abstract: Background-The literature suggests a lack of consensus on the use of terms related to coeliac disease (CD) and gluten.

Cited by 1,425 publications

References 209 publications

Celiac disease prevalence is not increased in patients with functional dyspepsia

Celiac disease prevalence is not increased in patients with functional dyspepsia

Intestinal anti-tissue transglutaminase antibodies in potential coeliac disease

A Remarkable Increase in Bone Mineral Density in Celiac Disease

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