Original articleAlimentary tractDegree of Damage to the Small Bowel and Serum Antibody Titers Correlate With Clinical Presentation of Patients With Celiac Disease
Section snippets
Materials and Methods
The study was based on 638 consecutive gastrointestinal endoscopies performed on 445 celiac disease patients at the Department of Gastroenterology and Alimentary Tract Surgery (Tampere University Hospital). All celiac disease diagnoses were based on the demonstration of small-bowel mucosal villous atrophy and crypt hyperplasia.2 Both newly diagnosed patients and patients on a gluten-free diet for at least 1 year were included.
Exclusion criteria for the study were inadequacy or poor quality of
Results
The baseline characteristics of the participants are shown in Table 1. The majority of the small-bowel mucosal biopsy specimens were from celiac patients with gastrointestinal symptoms, but up to 44% originated from subjects diagnosed by screening in at-risk groups or because of extraintestinal manifestations of celiac disease. All participants had the celiac disease–associated human leukocyte antigen types DQ2 or DQ8, or both. In untreated patients the mean Z-score was −0.10 in the lumbar
Discussion
The results showed significant correlations between the degree of small-bowel mucosal morphologic damage and most of the measured clinical outcomes in celiac disease. Of particular interest was the correlation observed between morphologic injury and patient-reported gastrointestinal symptoms and health-related quality of life. Interestingly, such correlation was present even in patients on a gluten-free diet, which would imply that in symptomatic subjects the mucosal structure remains
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Conflicts of interest The authors disclose no conflicts.
Funding This study and the Celiac Disease Study Group are supported by the Academy of Finland Research Council for Health, the Competitive Research Funding of the Pirkanmaa Hospital District, the Sigrid Juselius Foundation, the Maud Kuistila Foundation, the Foundation for Paediatric Research, the Ehrnrooth Foundation, and the Finnish Gastroenterology Society.