Genetic and flow cytometry analysis of seronegative celiac disease: a cohort study.
Scand J Gastroenterol
; 54(5): 563-570, 2019 May.
Article
en En
| MEDLINE
| ID: mdl-31057009
ABSTRACT
Background:
Seronegative celiac disease (CD) poses a diagnostic challenge.Aims:
Characterize and identify differences between seronegative and seropositive CD. Patients andmethods:
Retrospective cohort study examining adult patients diagnosed with CD (1980-2017). Clinical, analytical, histological, genetic and immunophenotypic data were compiled. Seronegative CD was defined as a anti-tissue transglutaminase type 2 IgA and endomysial antibodies (EMA) negative and HLA-DQ2 and/or DQ8 positive, showing clinical signs of CD plus an abnormal duodenal biopsy, and responding to a gluten-free diet (GFD). Factors associated with seronegative CD were identified through binomial logistic regression.Results:
Of 315 CD patients, 289 were seropositive (91.7%) and 26 seronegative (8.3%). Among the seronegative patients, higher prevalence was observed for autoimmune thyroiditis (26.9% vs. 9.7%, p = .016), HLA-DQ8 heterozygosity (23.1% vs. 2.5%, p Ë .001) and Marsh I lesion (34.6% vs. 3.7%, p Ë .001). The two groups showed similar flow cytometry-determined duodenal immunophenotypes and rates of refractory CD.Conclusions:
Seronegative CD differs mostly in genetic (more HLA-DQ8) and histologic (milder atrophy) features as compared with seropositive. Intestinal intraepithelial immunophenotype by flow cytometry, similar in both modalities, is a useful tool to diagnose seronegative CD.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Linfocitos
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Enfermedad Celíaca
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Duodeno
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Scand J Gastroenterol
Año:
2019
Tipo del documento:
Article
País de afiliación:
España