Genetic, morphometric and immunohistochemical markers of latent coeliac disease

Eur J Gastroenterol Hepatol. 1999 Nov;11(11):1283-8. doi: 10.1097/00042737-199911000-00017.


Background: It is recognized that coeliac disease may exist in a latent form characterized by HLA-DR3 and increased counts of intra-epithelial lymphocytes (IELs) and gamma/delta T cells in jejunal biopsies. To determine whether subjects with persistent serological markers 4 and 13 years after a population screening survey have the HLA constitution of coeliac disease and/or minor morphometric abnormalities of the small intestine, including raised gamma/delta T-cell counts, as possible indicators of latent coeliac disease.

Subjects: Participants with positive serology detected by the Belfast MONICA Project surveys (1983 and 1991) were subdivided into those with persistently positive serology (persistent serology), negative serology at follow-up (transient serology) and those with enteropathy (coeliac disease). Morphometric features were compared with MONICA controls who had negative serology and HLA antigen frequencies were compared with blood donor controls.

Methods: Subjects were followed up in 1994-1996 and were re-tested for IgA antibodies to gliadin, endomysium and reticulin. HLA typing was carried out and IELs and gamma/delta T-cell counts were assessed in jejunal biopsies in subjects who gave consent.

Results: Persistent serology mainly concerned antigliadin (AGA) and antireticulin (ARA) antibodies but one patient had positive antiendomysial antibody (EMA) and ARA in 1983, which became negative at follow-up, at which time they were positive for AGA. No significant differences were observed between IELs or gamma/delta T-cell counts when the persistent and transient groups were compared in turn with the MONICA controls. HLA-DR2 was expressed in 11 of 16 in the persistent group compared to 47 of 150 blood donor controls (P = 0.013). HLA-DR3 occurred in 15 of 17 coeliac patients compared to 37 of 150 blood donors (P = 0.00001).

Conclusions: Persistent serological markers following population screening do not appear to indicate latent coeliac disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Autoantibodies / blood
  • Biomarkers
  • Biopsy
  • Celiac Disease / diagnosis*
  • Celiac Disease / immunology*
  • Celiac Disease / pathology
  • Chronic Disease
  • Follow-Up Studies
  • Gliadin / immunology
  • HLA-DR Antigens / blood
  • Histocompatibility Testing
  • Humans
  • Immunoglobulin A / blood
  • Immunohistochemistry
  • Jejunum / pathology
  • Reticulin / immunology
  • Serologic Tests
  • T-Lymphocyte Subsets / immunology


  • Autoantibodies
  • Biomarkers
  • HLA-DR Antigens
  • Immunoglobulin A
  • Reticulin
  • Gliadin