Diagnosis of Seronegative and Ultrashort Celiac Disease.
| Autor: | Volta U; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. Electronic address: umberto.volta@unibo.it., Rostami K; Department of Gastroenterology MidCentral District Health Board, Palmerston, North New Zealand., Auricchio R; Department of Translational Medical Science, University Federico II, Naples, Italy., Lundin KEA; Department of Gastroenterology, Oslo University Hospital Rikshospitalet, Oslo, Norway; Norwegian Coeliac Disease Research Centre, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Gastroenterology [Gastroenterology] 2024 Jun; Vol. 167 (1), pp. 104-115. Date of Electronic Publication: 2024 Jan 28. |
| DOI: | 10.1053/j.gastro.2024.01.029 |
| Abstrakt: | In its conventional form, celiac disease (CeD) is characterized by both positive serology and flat villi in the duodenum, and is well known by gastroenterologists and general practitioners. The aim of this review was to shed light on 2 neglected and not yet well-defined celiac phenotypes, that is, seronegative and ultrashort CeD. Seronegative CeD can be suspected in the presence of flat villi, positive HLA-DQ2 and/or HLA-DQ8, and the absence of CeD antibodies. After ruling out other seronegative enteropathies, the diagnosis can be confirmed by both clinical and histologic improvements after 1 year of a gluten-free diet. Ultrashort CeD is characterized by the finding of flat villi in the duodenal bulb in the absence of mucosal damage in the distal duodenum and with serologic positivity. Data on the prevalence, clinical manifestations, histologic lesions, genetic features, and outcome of seronegative and ultrashort CeD are inconclusive due to the few studies available and the small number of patients diagnosed. Some additional diagnostic tools have been developed recently, such as assessing intestinal transglutaminase 2 deposits, flow cytometry technique, microRNA detection, or proteomic analysis, and they seem to be useful in the identification of complex cases. Further cooperative studies are highly desirable to improve the knowledge of these 2 still-obscure variants of CeD. (Copyright © 2024 AGA Institute. Published by Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
| Externí odkaz: |
|