Abstract | INTRODUCTION: METHODS: Symptomatic de novo adult patients with celiac disease were prospectively included. Clinical visits and dietary surveillance were scheduled every 6 months during a 2-year follow-up period. At each visit, fecal samples were collected and stored at -20 °C until analysis for gluten immunogenic peptides (f-GIPs). A follow-up duodenal biopsy was performed at 2 years. We evaluated the variables associated with persistent villous atrophy. RESULTS: Seventy-six patients completed the study (36.5 ± 1.6 years, 73% women); persistent villous atrophy was observed in 40 (53%), whereas 72.5% were asymptomatic and 75% had negative serology. Detectable f-GIP >0.08 μg/g in at least 1 fecal sample was seen in 69% of patients. There were no significant differences in the median f-GIP at each visit and median area under the curve over the serial measurements between patients with persistent villous atrophy and those who recovered. On multivariate analysis, only older age was associated with persistent villous atrophy (32% for 16-30 years; 67% for >30 years; P = 0.016). DISCUSSION: The rate of persistent villous atrophy after 2 years was high in adult patients with celiac disease on an intentionally strict gluten-free diet. Low-level ongoing inadvertent gluten exposure could be a contributing factor to persistent villous atrophy.
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Authors | Fernando Fernández-Bañares, Belén Beltrán, Antonio Salas, Isabel Comino, Raquel Ballester-Clau, Carme Ferrer, Javier Molina-Infante, Mercé Rosinach, Inés Modolell, Francisco Rodríguez-Moranta, Beatriz Arau, Verónica Segura, Luis Fernández-Salazar, Santos Santolaria, Maria Esteve, Carolina Sousa, CADER study group |
Journal | The American journal of gastroenterology
(Am J Gastroenterol)
Vol. 116
Issue 5
Pg. 1036-1043
(05 01 2021)
ISSN: 1572-0241 [Electronic] United States |
PMID | 33491958
(Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2021 by The American College of Gastroenterology. |
Topics |
- Adult
- Atrophy
- Biopsy
- Celiac Disease
(diet therapy, pathology)
- Diet, Gluten-Free
- Feces
(chemistry)
- Female
- Humans
- Intestinal Mucosa
(pathology)
- Male
- Microvilli
(pathology)
- Prospective Studies
- Spain
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