PMID- 18403944
OWN - NLM
STAT- MEDLINE
DCOM- 20080821
LR  - 20111117
IS  - 0954-691X (Print)
IS  - 0954-691X (Linking)
VI  - 20
IP  - 5
DP  - 2008 May
TI  - Gluten tolerance in adult patients with celiac disease 20 years after diagnosis?
PG  - 423-9
LID - 10.1097/MEG.0b013e3282f4de6e [doi]
AB  - BACKGROUND AND OBJECTIVE: Celiac disease (CD) is believed to be a permanent 
      intolerance to gluten. A number of patients, however, discontinue the gluten-free 
      diet (GFD) without developing symptoms or signs. The aim of our study was to 
      investigate whether CD patients are capable of developing tolerance to gluten. 
      METHODS: All 77 adult patients from our hospital known to have biopsy-proven CD 
      for more than 10 years were invited to participate. We investigated symptoms, 
      gluten consumption, antibodies for CD and other autoimmunity, human leukocyte 
      antigen (HLA)-typing, bone mineral density, and performed small bowel biopsies. 
      Tolerance was defined as no immunological or histological signs of CD while 
      consuming gluten. RESULTS: Sixty-six patients accepted participation, but after 
      review of the diagnostic biopsies 53 were found to have true CD. Twenty-three 
      percent of patients had a gluten-containing diet, 15% admitted gluten 
      transgression and 62% followed the GFD. Patients on a GFD had significantly more 
      osteoporosis. Normal small bowel mucosa was found in four of eight on 
      gluten-containing diet and in four of four with gluten transgression. Two 
      patients were considered to have developed tolerance to gluten. One of them was 
      HLA-DQ2/DQ8 negative. CONCLUSION: Development of tolerance to gluten seems 
      possible in some patients with CD. Further follow-up will show whether this 
      tolerance is permanent or only a long-term return to latency. This feature may be 
      associated with genetic characteristics, especially with HLA genotypes that 
      differ from DQ2 or DQ8. More insight into the mechanisms of the development of 
      gluten tolerance may help to distinguish those CD patients that might not require 
      life-long GFD.
FAU - Hopman, Erica G D
AU  - Hopman EG
AD  - Department of Dietetics and Nutrition, Leiden University Medical Center, Leiden, 
      The Netherlands. G.D.Hopman@lumc.nl
FAU - von Blomberg, Mary E
AU  - von Blomberg ME
FAU - Batstra, Manou R
AU  - Batstra MR
FAU - Morreau, Hans
AU  - Morreau H
FAU - Dekker, Friedo W
AU  - Dekker FW
FAU - Koning, Frits
AU  - Koning F
FAU - Lamers, Cor B H W
AU  - Lamers CB
FAU - Mearin, Maria Luisa
AU  - Mearin ML
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Eur J Gastroenterol Hepatol
JT  - European journal of gastroenterology & hepatology
JID - 9000874
RN  - 0 (Autoantibodies)
RN  - 0 (HLA-DQ Antigens)
RN  - 0 (HLA-DQ2 antigen)
RN  - 8002-80-0 (Glutens)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Autoantibodies/blood
MH  - Bone Density
MH  - Celiac Disease/*diet therapy/genetics/immunology/pathology
MH  - Female
MH  - Follow-Up Studies
MH  - Glutens/administration & dosage/*adverse effects/immunology
MH  - HLA-DQ Antigens/blood
MH  - Histocompatibility Testing
MH  - Humans
MH  - Immune Tolerance
MH  - Intestinal Mucosa/pathology
MH  - Intestine, Small/pathology
MH  - Male
MH  - Middle Aged
MH  - Patient Compliance
MH  - Severity of Illness Index
EDAT- 2008/04/12 09:00
MHDA- 2008/08/22 09:00
CRDT- 2008/04/12 09:00
PHST- 2008/04/12 09:00 [pubmed]
PHST- 2008/08/22 09:00 [medline]
PHST- 2008/04/12 09:00 [entrez]
AID - 00042737-200805000-00009 [pii]
AID - 10.1097/MEG.0b013e3282f4de6e [doi]
PST - ppublish
SO  - Eur J Gastroenterol Hepatol. 2008 May;20(5):423-9. doi: 
      10.1097/MEG.0b013e3282f4de6e.