Persistent villous atrophy in patients with celiac disease on a gluten-free diet is reported with increasing frequency.
Dr Antonio Carroccio and colleagues from Italy evaluated a possible association between persistent damage of the villi and ‘atypical’ gastrointestinal symptoms in celiac disease patients on a gluten-free diet.
The team divided 69 celiac disease patients on a gluten-free diet into 2 groups.
|Villous atrophy occurred in 85% in Group 1 vs 33% in Group 2|
|Scandinavian Journal of Gastroenterology
Group 1 evaluated 42 patients undergoing esophagogastroduodenoscopies due to the presence of symptoms.
Group 2 included 27 control patients who were asymptomatic at the time of the study.
Both groups underwent esophagogastroduodenoscopies, and a duodenal histologic study.
The researchers found persistent endoscopic lesions were more frequent in Group 1 than in Group 2.
Villous atrophy was significantly more frequent in Group 1 than in Group 2, at 85% versus 33%.
Gastrointestinal symptoms in Group 1 were different from those present at celiac disease diagnosis.
Anemia/diarrhea/weight loss occurred in 6 cases, whereas gastroesophageal reflux disease (GERD)-like symptoms in 12 cases, abdominal pain/constipation in 24 cases.
In Group 1, the team found no difference in gender distribution, age and duration of gluten-free diet between subjects with normal villi and those with persistent partial villous atrophy.
Patients with persistent symptoms showed a higher intraepithelial eosinophil count than the asymptomatic patients.
Dr Carroccio’s team concluded, “Persistent intestinal villous atrophy in celiac disease patients on a gluten-free diet is associated with gastrointestinal symptoms considered ‘atypical’ for celiac disease and not present at celiac disease diagnosis.”