Small-bowel mucosal inflammation in reticulin or gliadin antibody-positive patients without villous atrophy

Scand J Gastroenterol. 1998 Sep;33(9):944-9. doi: 10.1080/003655298750026967.


Background: We investigated whether individuals with positive coeliac disease antibodies but without small-bowel villous atrophy have mucosal inflammation implicating gluten-sensitivity.

Methods: Small-bowel mucosal morphology; CD3+, alphabeta+, and gammadelta+ T-cell receptor-bearing intraepithelial lymphocytes; and mucosal HLA-DR expression were studied in 96 IgA-class antireticulin or antigliadin antibody-positive adults suspected of having coeliac disease and in 27 control subjects.

Results: Villous atrophy compatible with coeliac disease was found in altogether 29 patients, in 18 of 21 (86%) patients with both antireticulin and antigliadin antibodies, in 9 of 15 (60%) patients with antireticulin antibodies only, and in 2 of 60 (3%) with antigliadin antibodies only. In 67 antibody-positive patients with normal villous architecture the densities of CD3+, alphabeta+, and gammadelta+ intraepithelial lymphocytes were significantly higher than in non-coeliac control subjects. Ten patients with initially increased densities of gammadelta+ T cells but normal villous structure underwent a follow-up biopsy after 4-18 months, which showed villous atrophy in five patients.

Conclusions: IgA-class antireticulin or antigliadin antibody-positive patients with normal small-bowel mucosal morphology frequently have immunohistochemical markers of coeliac disease latency. Together with our follow-up data this implies that they may be gluten-sensitive.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies / blood*
  • Atrophy
  • CD3 Complex / analysis
  • Celiac Disease / immunology*
  • Celiac Disease / pathology*
  • Female
  • Follow-Up Studies
  • Gliadin / immunology*
  • HLA-DR Antigens / analysis
  • Humans
  • Immunoglobulin A / analysis
  • Intestinal Mucosa / pathology
  • Intestine, Small / pathology*
  • Lymphocytes / immunology
  • Male
  • Middle Aged
  • Receptors, Antigen, T-Cell, alpha-beta / analysis
  • Receptors, Antigen, T-Cell, gamma-delta / analysis
  • Reticulin / immunology*


  • Antibodies
  • CD3 Complex
  • HLA-DR Antigens
  • Immunoglobulin A
  • Receptors, Antigen, T-Cell, alpha-beta
  • Receptors, Antigen, T-Cell, gamma-delta
  • Reticulin
  • Gliadin