A monocenter retrospective study of serological,histological and genetic characteristics of celiac disease in Northern Central Italy

Stefania Lombardi,Marco Culli,Isabella Giannelli,Antonella Puccini,Paolo Franceschini,Andrea Cavazzana,Daniela Tornaboni,Elena Bonomi,Marco Friggeri,Gloria Bertacca

doi:10.4236/ojcd.2013.33021

Abstract

Objective: To examine the seroprevalence, correlates and characteristics of Celiac disease (CD) in a population sample of a Northern Central Area of Italy, by a monocenter retrospective study. Methods: Between 2006 and 2010, serum samples of 9371 subjects (age range 6 months to 91 years) were screened for tissue transglutaminase IgA antibodies (IgA-tTG) by the Immunologia-Allergologia Unit of AUSL1 Massa-Carrara, an area with a population of approximately 150,000. Endomysial IgA antibodies (EMA), HLA typing and small-bowel biopsy were also performed when indicated. Results: Of the 9371 subjects, 269 (2.87%) had positive antibody tests. The population was divided into several age groups and the highest prevalence (5.63%) was found in the 6 months-3 years group. The prevalence of IgA-tTG positivity was double in females compared to males. All IgA-tTG positive patients that were genotyped carried HLA-DQ2 or DQ8, none was a5 positive only. In positive IgA-tTG sera, levels of IgA-tTG were significantly higher in EMA positive than in EMA negative sera (p in children and in adults. Ninety-five/269 IgA-tTG positive subjects underwent biopsy. IgA-tTG levels were different according to the histological degree of the lesion. When EMA were evaluated in IgA-tTG positive subjects the number of EMA negative sera was significantly higher in adults than in children. Conclusions: In summary, this study provides a monocenter retrospective analysis of serological, histological and genetic parameters of subjects with suspicion of CD in an area of Northern Central Italy from 2006 to 2010.

Highlights

Celiac disease (CD) is an autoimmune enteropathy characterized by chronic intestinal inflammation resulting in villous atrophy and flattening of the small intestinal mucosa
Considered a rare malabsorption syndrome in childhood, CD is recognized as a common disorder that may arise at any age, with growing proportion of new cases diagnosed in adults and patients with extraintestinal manifestations, such as esophageal reflux, osteoporosis, hypertransaminasemia and neurological symptoms [1,2]
The pediatric population is divided into female and male subjects; on the contrary, in the adult group, female subjects are more than double compared to male subjects

Summary

Introduction

Celiac disease (CD) is an autoimmune enteropathy characterized by chronic intestinal inflammation resulting in villous atrophy and flattening of the small intestinal mucosa. CD is one of the most common lifelong diseases in western countries, most affected individuals remain undiagnosed [3]. This is apparently because many patients have atypical symptoms or none at all. The disease is characterized by the production of anti-tissue transglutaminase (IgA-tTG) and anti-endomysial IgA (EMA) antibodies [4,5,6]. IgA-tTG and EMA appear to be good markers of the active phase of the disease, the definitive diagnosis requires a small-bowel biopsy showing the typical histological abnormalities (villous atrophy, crypt hyperplasia and intraepithelial lymphocytes) [7]. Population based studies have shown that the prevalences of CD in Europe and North America

Methods

Results

Conclusion