New entity of adult ultra-short coeliac disease: the first international cohort and case-control study.

Autor:	Raju SA; Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK suneilraju@gmail.com.; Division of Clinical Medicine, Faculty of Medicine and Population Health, The University of Sheffield Medical School, Sheffield, UK., Greenaway EA; Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.; Division of Clinical Medicine, Faculty of Medicine and Population Health, The University of Sheffield Medical School, Sheffield, UK., Schiepatti A; Gastroenterology Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.; Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy., Arpa G; Department of Molecular Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.; Anatomical Pathology Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy., Vecchione N; Department of Medicine, Surgery, Dentistry, University of Salerno, Fisciano, Italy., Jian C; Gastroenterology and Hepatology, MidCentral District Health Board, Palmerston North, New Zealand., Grobler C; Medlab Central Limited, Palmerston North, New Zealand., Maregatti M; Center for Prevention and Diagnosis of Celiac Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy., Green O; Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.; Division of Clinical Medicine, Faculty of Medicine and Population Health, The University of Sheffield Medical School, Sheffield, UK., Bowker-Howell FJ; Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.; Division of Clinical Medicine, Faculty of Medicine and Population Health, The University of Sheffield Medical School, Sheffield, UK., Shiha MG; Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.; Division of Clinical Medicine, Faculty of Medicine and Population Health, The University of Sheffield Medical School, Sheffield, UK., Penny HA; Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.; Division of Clinical Medicine, Faculty of Medicine and Population Health, The University of Sheffield Medical School, Sheffield, UK., Cross SS; Division of Clinical Medicine, Faculty of Medicine and Population Health, The University of Sheffield Medical School, Sheffield, UK., Ciacci C; Department of Medicine, Surgery, Dentistry, University of Salerno, Fisciano, Italy., Rostami K; Department of Gastroenterology, MidCentral District Health Board, Palmerston North, New Zealand., Ahmadipour S; Hepatitis ResearcH Center, Lorestan University of Medical Sciences, Khoram-Abad, Iran (the Islamic Republic of)., Moradi A; School of Medicine, Department of Pathology, Shahid Beheshti University of Medical Sciences, Tehran, Iran (the Islamic Republic of)., Rostami-Nejad M; Celiac Disease and Gluten Related Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran (the Islamic Republic of)., Biagi F; Gastroenterology Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.; Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy., Volta U; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy., Fiorentino M; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy., Lebwohl B; Celiac Disease Center, Columbia University Medical Center, New York, New York, USA., Green PH; Celiac Disease Center, Columbia University Medical Center, New York, New York, USA., Lewis S; Celiac Disease Center, Columbia University Medical Center, New York, New York, USA., Molina-Infante J; Department of Gastroenterology, Centro de Investigación Biomédica en Red, Madrid, Spain.; Department of Gastroenterology, Hospital Universitario de Caceres, Caceres, Spain., Mata-Romero P; Department of Gastroenterology, Hospital Universitario de Caceres, Caceres, Spain., Vaira V; Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy.; Division of Pathology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milano, Italy., Elli L; Center for Prevention and Diagnosis of Celiac Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy., Soykan I; Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey., Ensari A; Department of Pathology, Ankara University Faculty of Medicine, Ankara, Turkey., Sanders DS; Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.; Division of Clinical Medicine, Faculty of Medicine and Population Health, The University of Sheffield Medical School, Sheffield, UK.
Jazyk:	angličtina
Zdroj:	Gut [Gut] 2024 Jun 06; Vol. 73 (7), pp. 1124-1130. Date of Electronic Publication: 2024 Jun 06.
DOI:	10.1136/gutjnl-2023-330913
Abstrakt:	Background: Ultra-short coeliac disease (USCD) is defined as villous atrophy only present in the duodenal bulb (D1) with concurrent positive coeliac serology. We present the first, multicentre, international study of patients with USCD. Methods: Patients with USCD were identified from 10 tertiary hospitals (6 from Europe, 2 from Asia, 1 from North America and 1 from Australasia) and compared with age-matched and sex-matched patients with conventional coeliac disease. Findings: Patients with USCD (n=137, median age 27 years, IQR 21-43 years; 73% female) were younger than those with conventional coeliac disease (27 vs 38 years, respectively, p<0.001). Immunoglobulin A-tissue transglutaminase (IgA-tTG) titres at index gastroscopy were lower in patients with USCD versus conventional coeliac disease (1.8×upper limit of normal (ULN) (IQR 1.1-5.9) vs 12.6×ULN (IQR 3.3-18.3), p<0.001).Patients with USCD had the same number of symptoms overall (median 3 (IQR 2-4) vs 3 (IQR 1-4), p=0.875). Patients with USCD experienced less iron deficiency (41.8% vs 22.4%, p=0.006).Both USCD and conventional coeliac disease had the same intraepithelial lymphocytes immunophenotype staining pattern; positive for CD3 and CD8, but not CD4.At follow-up having commenced a gluten-free diet (GFD) (median of 1181 days IQR: 440-2160 days) both USCD and the age-matched and sex-matched controls experienced a similar reduction in IgA-tTG titres (0.5 ULN (IQR 0.2-1.4) vs 0.7 ULN (IQR 0.2-2.6), p=0.312). 95.7% of patients with USCD reported a clinical improvement in their symptoms. Interpretation: Patients with USCD are younger, have a similar symptomatic burden and benefit from a GFD. This study endorses the recommendation of D1 sampling as part of the endoscopic coeliac disease diagnostic workup. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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