Exploring undiagnosed celiac disease in women with recurrent reproductive failure: The gluten-free diet could improve reproductive outcomes

Autor: Natalia López-Palacios, Mercedes Castaño, Pilar Aparicio, Concepción Núñez, Juan A. Garcia-Velasco, Diana Alecsandru
Rok vydání: 2019
Předmět:
0301 basic medicine
Delayed Diagnosis
Pregnancy Rate
Biopsy
Disease
Autoantigens
Gliadin
Serology
0302 clinical medicine
Antibody Specificity
HLA Antigens
Pregnancy
Recurrent miscarriage
Immunology and Allergy
chemistry.chemical_classification
030219 obstetrics & reproductive medicine
medicine.diagnostic_test
Pregnancy Outcome
Obstetrics and Gynecology
Middle Aged
Female
Live Birth
Adult
medicine.medical_specialty
Abortion
Habitual
Duodenum
Immunology
Fertilization in Vitro
03 medical and health sciences
Diet
Gluten-Free
GTP-Binding Proteins
Internal medicine
medicine
Seroprevalence
Humans
Protein Glutamine gamma Glutamyltransferase 2
Antigens
Autoantibodies
Retrospective Studies
Transglutaminases
business.industry
Retrospective cohort study
medicine.disease
Gluten
Immunoglobulin A
Celiac Disease
030104 developmental biology
Reproductive Medicine
chemistry
Immunoglobulin G
Gluten free
Embryo Implantation
Delayed
business
Zdroj: American journal of reproductive immunology (New York, N.Y. : 1989)REFERENCES. 83(2)
ISSN: 1600-0897
Popis: Problem Which is the prevalence and seroprevalence of celiac disease (CD) in women with recurrent reproductive failure? Method of study Retrospective study performed in a single infertility clinic from September 2016 to December 2017. A total of 690 women with unexplained history of recurrent miscarriage and/or recurrent implantation failure were consecutively recruited. IgA anti-transglutaminase 2 (TG2) antibody data were collected, as well as IgG anti-TG2 and IgA/IgG anti-deamidated gluten peptide (DGP) data in most cases, and IgG anti-gliadin antibodies occasionally. In selected women, HLA-DQ genotyping was requested. Biopsy was suggested to all women with positive serological results or belonging to CD risk groups. Reproductive outcomes were recorded from women with high suspicion of CD and a control group comprised of 49 women. Results Anti-TG2-positive women comprised 1% of the sample. An additional 4% was observed considering less-specific antibodies (31 women). Only 39% of sero-positive women accepted duodenal biopsy. HLA and biopsy data discarded CD in 14 sero-positive cases (37%), only one with anti-TG2 antibodies. CD was suggested in 10 sero-positive and three sero-negative women (1.9%). Compared with controls, the live birthrate of the studied women with probable CD was significantly decreased before gluten removal of the diet (P = .015), but significantly increased after that (P = .020). Conclusion One percent CD prevalence should be expected after anti-TG2 serological screening. However, more sensitive approaches should be explored, especially considering the potential beneficial effect of the gluten-free diet on the reproductive outcomes of women with CD.
Databáze: OpenAIRE
Externí odkaz: