Predictivity of Autoimmune Stigmata for Gluten Sensitivity in Subjects with Microscopic Enteritis: A Retrospective Study

Nutrients. 2018 Dec 18;10(12):2001. doi: 10.3390/nu10122001.

Abstract

Non-celiac gluten sensitivity (NCGS) is an emerging gluten-related condition. We investigated whether the presence of autoimmune stigmata in a group of patients with clinical suspicion of NCGS and a histological picture of microscopic enteritis (ME) could be a predictive factor of NCGS. Patients with ME were followed up by periodical examinations. At baseline, we collected data about previous clinical history, including autoimmune diseases. NCGS was diagnosed according to Salerno criteria; other causes of ME were diagnosed according to well-established protocols. Patients with celiac disease were excluded. Student's and chi-square tests were used in univariate analysis. Kaplan-Meier curves and Cox regression were used to estimate hazard ratios (HR). Sixty-three patients were included. Twenty-two had a final diagnosis of NCGS; the remaining 41 had non-gluten-related causes of ME. Prevalence of autoimmune thyroiditis was higher among NCGS patients (40.1%) than in other ME (14.6%; p = 0.03). NCGS showed higher positivity rate for anti-gliadin (27.3% versus 2.5%; p = 0.006) and anti-nucleus (45.4% versus 12.2%; p = 0.005). Autoimmune thyroiditis had a non-significant trend (p = 0.06) for NCGS diagnosis, (HR = 2.4). Both anti-gliadin (HR = 2.4; p = 0.04) and anti-nucleus (HR = 2.7; p = 0.04) were directly associated with NCGS diagnosis. In conclusion, NCGS may have a cohort of autoimmune stigmata that can precede its diagnosis.

Keywords: anti-gliadin; anti-nucleus antibody; autoimmunity; gluten sensitivity; thyroiditis.

MeSH terms

  • Adult
  • Autoimmune Diseases / diagnosis
  • Autoimmune Diseases / immunology*
  • Autoimmune Diseases / pathology
  • Enteritis / diagnosis
  • Enteritis / etiology
  • Enteritis / immunology*
  • Enteritis / pathology
  • Female
  • Food Hypersensitivity / diagnosis
  • Food Hypersensitivity / immunology*
  • Food Hypersensitivity / pathology
  • Gliadin / immunology
  • Glutens / adverse effects*
  • Glutens / immunology
  • Humans
  • Kaplan-Meier Estimate
  • Malabsorption Syndromes / diagnosis
  • Malabsorption Syndromes / immunology*
  • Malabsorption Syndromes / pathology
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Retrospective Studies
  • Thyroiditis, Autoimmune / complications
  • Thyroiditis, Autoimmune / immunology
  • Young Adult

Substances

  • Glutens
  • Gliadin