An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity

BMC Medicine

Gino Roberto Corazza¹  Riccardo Troncone⁴  Antonino Calabrò³  Maria Teresa Bardella⁵  Umberto Volta² 

[1] First Department of Internal Medicine, St. Matteo Hospital, University of Pavia, Pavia, Italy;Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy;Gastroenterology Unit, University of Florence, Firenze, Italy;Department of Pediatrics, University Federico II, Naples, Italy;IRCCS Ca’ Granda, University of Milan, Milano, Italy

关键词: Anti-gliadin antibodies;    Duodenal biopsy;    Clinical picture;    Prospective survey;    Celiac disease;    Non-celiac gluten sensitivity;   

Others  :  854876
DOI  :  10.1186/1741-7015-12-85

 received in 2014-02-25, accepted in 2014-03-31,  发布年份 2014

【 摘 要 】

Background

Non-celiac gluten sensitivity (NCGS) is still an undefined syndrome with several unsettled issues despite the increasing awareness of its existence. We carried out a prospective survey on NCGS in Italian centers for the diagnosis of gluten-related disorders, with the aim of defining the clinical picture of this new syndrome and to establish roughly its prevalence compared with celiac disease.

Methods

From November 2012 to October 2013, 38 Italian centers (27 adult gastroenterology, 5 internal medicine, 4 pediatrics, and 2 allergy) participated in this prospective survey. A questionnaire was used in order to allow uniform and accurate collection of clinical, biochemical, and instrumental data.

Results

In total, 486 patients with suspected NCGS were identified in this 1-year period. The female/male ratio was 5.4 to 1, and the mean age was 38 years (range 3–81). The clinical picture was characterized by combined gastrointestinal (abdominal pain, bloating, diarrhea and/or constipation, nausea, epigastric pain, gastroesophageal reflux, aphthous stomatitis) and systemic manifestations (tiredness, headache, fibromyalgia-like joint/muscle pain, leg or arm numbness, 'foggy mind,' dermatitis or skin rash, depression, anxiety, and anemia). In the large majority of patients, the time lapse between gluten ingestion and the appearance of symptoms varied from a few hours to 1 day. The most frequent associated disorders were irritable bowel syndrome (47%), food intolerance (35%) and IgE-mediated allergy (22%). An associated autoimmune disease was detected in 14% of cases. Regarding family history, 18% of our patients had a relative with celiac disease, but no correlation was found between NCGS and positivity for HLA-DQ2/-DQ8. IgG anti-gliadin antibodies were detected in 25% of the patients tested. Only a proportion of patients underwent duodenal biopsy; for those that did, the biopsies showed normal intestinal mucosa (69%) or mild increase in intraepithelial lymphocytes (31%). The ratio between suspected NCGS and new CD diagnoses, assessed in 28 of the participating centers, was 1.15 to 1.

Conclusions

This prospective survey shows that NCGS has a strong correlation with female gender and adult age. Based on our results, the prevalence of NCGS seems to be only slightly higher than that of celiac disease.

Please see related article http://www.biomedcentral.com/1741-7015/12/86 webcite.

【 授权许可】

   
2014 Volta et al.; licensee BioMed Central Ltd.

【 图 表 】

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