Intestinal antibody pattern of celiac disease: occurrence in patients with normal jejunal biopsy histology

Gastroenterology. 1993 May;104(5):1263-72. doi: 10.1016/0016-5085(93)90333-8.


Background: Patients with celiac disease have immunoglobulin (Ig) M antibodies and IgA antigliadin antibody in gut secretions; this pattern of intestinal immunity may be a marker of latent celiac disease. Its frequency in patients referred for jejunal biopsy has been examined.

Methods: Serum IgG and IgA antigliadin antibody, jejunal fluid IgA and IgM antibodies to gliadin, ovalbumin and beta lactoglobulin, and jejunal fluid IgA and IgM concentrations were measured by enzyme-linked immunosorbent assay.

Results: Seventeen of 19 celiac patients on normal diet and 16 of 23 on gluten-free diet had the celiaclike antibody pattern, as did 41 of 217 other patients. Jejunal biopsy histology had been classified as normal in 38 of these, with minor abnormalities in 3; however, intraepithelial lymphocyte (IEL) counts were high in 13 cases. Trial of a gluten-free diet produced clinical improvement in 6 of 7 antibody-positive patients. After extra dietary gluten, one developed subtotal villous atrophy.

Conclusions: The celiaclike intestinal antibody pattern and a high IEL count may be markers of latent gluten-sensitive enteropathy; some of these patients are clinically gluten sensitive in the absence of enteropathy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies / analysis*
  • Biopsy
  • Celiac Disease / immunology*
  • Celiac Disease / pathology
  • Dermatitis Herpetiformis / immunology
  • Diet
  • Female
  • Food Hypersensitivity / immunology
  • Gliadin / immunology
  • Glutens / administration & dosage
  • Glutens / pharmacology
  • Humans
  • Intestines / immunology*
  • Jejunum / pathology*
  • Male
  • Middle Aged
  • Reference Values


  • Antibodies
  • Glutens
  • Gliadin