Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 16 December 2017

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Most patients with seronegative villous atrophy do not have celiac disease

The latest issue of Gut reports on the clinical and phenotypical assessment of seronegative villous atrophy in a large adult cohort studied over a 15-year period.

News image

Seronegative villous atrophy is commonly attributed to celiac disease.

However, there are other causes of seronegative villous atrophy.

More recently angiotensin-2-receptor-blockers have been reported as an association but data on seronegative villous atrophy have been limited to centers evaluating complex case referrals, and not seronegative villous atrophy in general.

Dr David Sanders and colleagues from the United Kingdom provide clinical outcomes and associations in a large prospective study overseeing all newcomers with seronegative villous atrophy.

Over a 15-year period, the team evaluated 200 adult patients with seronegative villous atrophy at a UK center.

Of the 200 seronegative villous atrophy cases, seronegative-non-celiac disease represented 69%
Gut

A diagnosis of either seronegative celiac disease or seronegative non-celiac disease was reached.

The researchers made baseline comparisons between the groups, with 343 seropositive celiac disease subjects serving as controls.

Of the 200 seronegative villous atrophy cases, seronegative celiac disease represented 31% and seronegative-non-celiac disease 69%.

The researchers observed that human leucocyte antigen (HLA)-DQ2 and/or DQ8 genotype was present in 61%, with a 51% positive predictive value for seronegative-non-celiac disease.

The breakdown of identifiable causes in the seronegative-non-celiac disease group comprized infections, inflammatory/immune-mediated disorders, and drugs.

However, the research team found no cause in 18%, and of these, 72% spontaneously normalized duodenal histology while consuming a gluten-enriched diet.

The researchers observed that an independent factor associated with seronegative-non-celiac disease was non-white ethnicity.

The team noted that 66% of non-whites had GI infections.

On immunohistochemistry all groups stained positive for CD8-T-cytotoxic intraepithelial lymphocytes.

However, additional CD4-T helper intraepithelial lymphocytes were occasionally seen in seronegative-non-celiac disease mimicking the changes associated with refractory celiac disease.

Dr Sanders' team concluded, "Most patients with seronegative villous atrophy do not have celiac disease, in particular those who are not white."

"Furthermore, a subgroup with no obvious etiology will show spontaneous histological resolution while consuming gluten."

"These findings suggest caution in empirically prescribing a gluten-free diet without investigation."

Gut 2017;66:1563-1572
16 August 2017

Go to top of page Email this page Email this page to a colleague

 15 December 2017 
Molecular classification of Crohn's disease
 15 December 2017 
Medical cannabinoid legalization policy and vomiting
 15 December 2017 
Inflammatory diet pattern and colorectal cancer risk
 14 December 2017 
PPIs and gastric cancer after H.pylori eradication
 14 December 2017 
H. pylori eradication therapies in countries with clarithromycin resistance
 14 December 2017 
Reliability of the IBD index
 13 December 2017 
Tryptophan metabolism and IBD activity
 13 December 2017 
Disease severity in NAFLD
 13 December 2017 
Management of abnormal liver blood tests
 12 December 2017 
Risk factors in undiagnosed cirrhosis
 12 December 2017 
Monitored anesthesia care for outpatient GI endoscopy
 12 December 2017 
High-risk colorectal cancer patients
 06 December 2017 
Reflux-induced chronic cough 
 06 December 2017 
Preventing hepatic encephalopathy-related readmissions
 06 December 2017 
Systemic inflammatory response syndrome in acute-on-chronic liver failure
 05 December 2017 
Childhood obesity into adulthood
 05 December 2017 
CT imaging for acute diverticulitis
 05 December 2017 
Thiopurines and colorectal cancer in IBD
 04 December 2017 
Neoadjuvant chemoradiation for locally advanced rectal cancer
 04 December 2017 
Physical activity and Barrett’s esophagus
 04 December 2017 
Alcohol abstinence and alcoholic hepatitis
 01 December 2017 
Therapeutic drug monitoring in IBD
 01 December 2017 
Insulin therapy and liver cancer among diabetics
 01 December 2017 
Family burden of pediatric Crohn's in the USA
 30 November 2017 
Anastomotic leak after repeat intestinal resection in Crohn’s
 30 November 2017 
Oral capsule– vs colonoscopy-delivered fecal microbiota transplant
 30 November 2017 
Sessile serrated polyps and H. pylori in the USA
 29 November 2017 
Predicting mortality after colectomy for C. diff
 29 November 2017 
Obesity and cancer risk
 28 November 2017 
Surgical treatment delays and colon cancer survival
 28 November 2017 
Celiac disease screening in adult first-degree relatives
 28 November 2017 
Electronic health record alert in primary care in Hep C
 27 November 2017 
Questionnaire fore chronic constipation
 27 November 2017 
Challenges in measuring the affordability of US health care
 27 November 2017 
Early readmission in IBD patients
 24 November 2017 
Osteoporotic fractures in Barrett's esophagus
 24 November 2017 
Center ERCP volume and procedure success
 24 November 2017 
Adipokines and IBD
 23 November 2017 
Pharmacological management of GERD
 23 November 2017 
Incidence of biopsy-verified celiac disease
 23 November 2017 
Distance travelling for rectal cancer outcomes
 22 November 2017 
Challenges of US-trained gastroenterologists when abroad
 22 November 2017 
Surgical treatment delays influence survival in colon cancer
 22 November 2017 
Golimumab in Crohn's disease
 21 November 2017 
Preoperative optimization in IBD patients
 21 November 2017 
Cholangiopathy in critically ill patients
 21 November 2017 
Prepregnancy obesity and maternal mortality
 20 November 2017 
Barriers to hepatitis C treatment
 20 November 2017 
Socioeconomic characteristics in diverticular disease
 20 November 2017 
Endoscopic indices of disease activity for Crohn’s
 17 November 2017 
Predicting microscopic colitis
 17 November 2017 
PPI use and cognitive function in women
 17 November 2017 
Food elimination diets for treatment of adults with eosinophilic esophagitis
 16 November 2017 
NAFLD-hepatocellular carcinoma and survival after orthotopic liver transplant
 16 November 2017 
Prepregnancy obesity and severe maternal morbidity
 16 November 2017 
Celiac disease screening in adult first-degree relatives
 15 November 2017 
Breastfeeding and the risk of IBD
 15 November 2017 
Predicting recurrence after curative rectal cancer surgery
 15 November 2017 
Medication nonadherence and health care costs
 14 November 2017 
Eosinophilic gastroenteritis and colitis

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2017 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us