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Gluten sensitivity in patients with primary biliary cirrhosis
S Niveloni1, R Dezi, S Pedreira
1Clinical Department, Hospital de Gastroenterología Dr Carlos Bonorino Udaondo, Universidad del Salvador, Buenos Aires, Argentina.
The American Journal of Gastroenterology
|May 15, 1998
Summary
Features of gluten sensitivity were found in a significant portion of primary biliary cirrhosis patients. This suggests a potential link between gluten intolerance and this liver condition, warranting further investigation.
Area of Science:
- Gastroenterology and Hepatology
- Immunology
- Genetics
Background:
- Celiac disease and primary biliary cirrhosis can coexist, but the frequency is unclear.
- Celiac disease is now understood as a broader gluten-driven immunological response.
- Assessing gluten sensitivity in primary biliary cirrhosis patients is important for understanding this association.
Purpose of the Study:
- To evaluate the prevalence and characteristics of gluten sensitivity in patients diagnosed with primary biliary cirrhosis.
- To investigate the immunological and histological markers of gluten intolerance in this cohort.
Main Methods:
- Ten primary biliary cirrhosis patients were assessed for gluten sensitivity markers.
- Methods included serum antibody testing (antigliadin, endomysial), small bowel histology, HLA genotyping (DQ2), and rectal gluten challenge.
- Rectal gluten challenge involved assessing intraepithelial lymphocyte response to local gluten instillation.
Main Results:
- Three out of ten patients showed evidence of gluten sensitivity.
- These three patients had abnormal antigliadin antibodies, and one had positive endomysial antibodies.
- Two patients exhibited partial villous atrophy, and all three showed a celiac-like rectal response to gluten; characteristic HLA genotypes were present in these three.
Conclusions:
- A notable proportion of primary biliary cirrhosis patients demonstrated features of gluten sensitivity.
- Despite immunological and histological evidence, symptoms of celiac disease were minimal or absent.
- Further research is needed to clarify the clinical significance of gluten sensitivity in primary biliary cirrhosis.