NON-CELIAC GLUTEN/WHEAT SENSITIVITY (NCG/WS). A BRAZILIAN CASES SERIES.

Area of Science:

• Gastroenterology
• Immunology
• Dietary Science

Background:

• Non-celiac gluten/wheat sensitivity (NCGWS) presents with gluten-related symptoms, distinct from celiac disease (CD) and wheat allergy.
• Limited data exists on NCGWS in the Brazilian population.
• This study aims to characterize Brazilian NCGWS patients and compare features between sexes.

Purpose of the Study:

• To describe clinical, serological, and histopathological features of Brazilian NCGWS patients.
• To compare demographic and clinical findings between male and female NCGWS patients.
• To evaluate the efficacy of a gluten-free diet (GFD) in managing NCGWS symptoms.

Main Methods:

• Retrospective analysis of 36 NCGWS patients diagnosed between 2015-2025 in Curitiba, Brazil.
• Diagnosis involved excluding CD and wheat allergy, confirmed by GFD response and Marsh 0/I duodenal histology.
• Serological tests (anti-endomysium, anti-transglutaminase) and duodenal biopsies were analyzed; symptoms and demographics were compared by sex.

Main Results:

• NCGWS was more prevalent in women (83.3%).
• All patients had negative CD serology; duodenal biopsies revealed Marsh 0 (80% females, 100% males) or Marsh I.
• Gastrointestinal symptoms like flatulence and distension were common; diarrhea was more frequent in males (P=0.0017).
• All patients experienced symptom improvement on a GFD within two months.

Conclusions:

• NCGWS in this Brazilian cohort predominantly affected women.
• Accurate NCGWS diagnosis requires integrating histological, serological, and comprehensive clinical evaluations.
• Multidisciplinary care and personalized dietary guidance are crucial for effective NCGWS management.