An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity
Non-celiac gluten sensitivity (NCGS) is still an undefined syndrome with several unsettled issues despite the increasing awareness of its existence. We carried out a prospective survey on NCGS in Italian centers for the diagnosis of gluten-related disorders, with the aim of defining the clinical pic...
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| Veröffentlicht in: | BMC medicine 2014-05, Vol.12 (1), p.85-85, Article 85 |
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| description | Non-celiac gluten sensitivity (NCGS) is still an undefined syndrome with several unsettled issues despite the increasing awareness of its existence. We carried out a prospective survey on NCGS in Italian centers for the diagnosis of gluten-related disorders, with the aim of defining the clinical picture of this new syndrome and to establish roughly its prevalence compared with celiac disease.
From November 2012 to October 2013, 38 Italian centers (27 adult gastroenterology, 5 internal medicine, 4 pediatrics, and 2 allergy) participated in this prospective survey. A questionnaire was used in order to allow uniform and accurate collection of clinical, biochemical, and instrumental data.
In total, 486 patients with suspected NCGS were identified in this 1-year period. The female/male ratio was 5.4 to 1, and the mean age was 38 years (range 3-81). The clinical picture was characterized by combined gastrointestinal (abdominal pain, bloating, diarrhea and/or constipation, nausea, epigastric pain, gastroesophageal reflux, aphthous stomatitis) and systemic manifestations (tiredness, headache, fibromyalgia-like joint/muscle pain, leg or arm numbness, 'foggy mind,' dermatitis or skin rash, depression, anxiety, and anemia). In the large majority of patients, the time lapse between gluten ingestion and the appearance of symptoms varied from a few hours to 1 day. The most frequent associated disorders were irritable bowel syndrome (47%), food intolerance (35%) and IgE-mediated allergy (22%). An associated autoimmune disease was detected in 14% of cases. Regarding family history, 18% of our patients had a relative with celiac disease, but no correlation was found between NCGS and positivity for HLA-DQ2/-DQ8. IgG anti-gliadin antibodies were detected in 25% of the patients tested. Only a proportion of patients underwent duodenal biopsy; for those that did, the biopsies showed normal intestinal mucosa (69%) or mild increase in intraepithelial lymphocytes (31%). The ratio between suspected NCGS and new CD diagnoses, assessed in 28 of the participating centers, was 1.15 to 1.
This prospective survey shows that NCGS has a strong correlation with female gender and adult age. Based on our results, the prevalence of NCGS seems to be only slightly higher than that of celiac disease. |
| doi_str_mv | 10.1186/1741-7015-12-85 |
| format | Article |
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From November 2012 to October 2013, 38 Italian centers (27 adult gastroenterology, 5 internal medicine, 4 pediatrics, and 2 allergy) participated in this prospective survey. A questionnaire was used in order to allow uniform and accurate collection of clinical, biochemical, and instrumental data.
In total, 486 patients with suspected NCGS were identified in this 1-year period. The female/male ratio was 5.4 to 1, and the mean age was 38 years (range 3-81). The clinical picture was characterized by combined gastrointestinal (abdominal pain, bloating, diarrhea and/or constipation, nausea, epigastric pain, gastroesophageal reflux, aphthous stomatitis) and systemic manifestations (tiredness, headache, fibromyalgia-like joint/muscle pain, leg or arm numbness, 'foggy mind,' dermatitis or skin rash, depression, anxiety, and anemia). In the large majority of patients, the time lapse between gluten ingestion and the appearance of symptoms varied from a few hours to 1 day. The most frequent associated disorders were irritable bowel syndrome (47%), food intolerance (35%) and IgE-mediated allergy (22%). An associated autoimmune disease was detected in 14% of cases. Regarding family history, 18% of our patients had a relative with celiac disease, but no correlation was found between NCGS and positivity for HLA-DQ2/-DQ8. IgG anti-gliadin antibodies were detected in 25% of the patients tested. Only a proportion of patients underwent duodenal biopsy; for those that did, the biopsies showed normal intestinal mucosa (69%) or mild increase in intraepithelial lymphocytes (31%). The ratio between suspected NCGS and new CD diagnoses, assessed in 28 of the participating centers, was 1.15 to 1.
This prospective survey shows that NCGS has a strong correlation with female gender and adult age. Based on our results, the prevalence of NCGS seems to be only slightly higher than that of celiac disease.</description><identifier>ISSN: 1741-7015</identifier><identifier>EISSN: 1741-7015</identifier><identifier>DOI: 10.1186/1741-7015-12-85</identifier><identifier>PMID: 24885375</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Antibodies ; Barley ; Celiac disease ; Celiac Disease - epidemiology ; Cereals ; Child ; Child, Preschool ; Comparative analysis ; Diagnosis ; Diet, Gluten-Free ; Female ; Food Hypersensitivity - epidemiology ; Food Hypersensitivity - etiology ; Gastroenterology ; Gastrointestinal Diseases - epidemiology ; Gastrointestinal Diseases - etiology ; Gluten ; Glutens - adverse effects ; HLA-DQ Antigens - immunology ; Humans ; Internal medicine ; Intestinal Mucosa - immunology ; Irritable bowel syndrome ; Italy - epidemiology ; Male ; Middle Aged ; Nutrition research ; Patients ; Pediatrics ; Prevalence ; Prospective Studies ; Questionnaires ; Sex Factors ; Skin diseases ; Statistics ; Surveys ; Surveys and Questionnaires ; Young Adult</subject><ispartof>BMC medicine, 2014-05, Vol.12 (1), p.85-85, Article 85</ispartof><rights>COPYRIGHT 2014 BioMed Central Ltd.</rights><rights>2014 Volta et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Copyright © 2014 Volta et al.; licensee BioMed Central Ltd. 2014 Volta et al.; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b604t-e7074dc3e99c7054b999753ce350d0f02995ca4c89a61bc4876447809fcc29d53</citedby><cites>FETCH-LOGICAL-b604t-e7074dc3e99c7054b999753ce350d0f02995ca4c89a61bc4876447809fcc29d53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4053283/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4053283/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24885375$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Volta, Umberto</creatorcontrib><creatorcontrib>Bardella, Maria Teresa</creatorcontrib><creatorcontrib>Calabrò, Antonino</creatorcontrib><creatorcontrib>Troncone, Riccardo</creatorcontrib><creatorcontrib>Corazza, Gino Roberto</creatorcontrib><creatorcontrib>Study Group for Non-Celiac Gluten Sensitivity</creatorcontrib><creatorcontrib>The Study Group for Non-Celiac Gluten Sensitivity</creatorcontrib><title>An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity</title><title>BMC medicine</title><addtitle>BMC Med</addtitle><description>Non-celiac gluten sensitivity (NCGS) is still an undefined syndrome with several unsettled issues despite the increasing awareness of its existence. We carried out a prospective survey on NCGS in Italian centers for the diagnosis of gluten-related disorders, with the aim of defining the clinical picture of this new syndrome and to establish roughly its prevalence compared with celiac disease.
From November 2012 to October 2013, 38 Italian centers (27 adult gastroenterology, 5 internal medicine, 4 pediatrics, and 2 allergy) participated in this prospective survey. A questionnaire was used in order to allow uniform and accurate collection of clinical, biochemical, and instrumental data.
In total, 486 patients with suspected NCGS were identified in this 1-year period. The female/male ratio was 5.4 to 1, and the mean age was 38 years (range 3-81). The clinical picture was characterized by combined gastrointestinal (abdominal pain, bloating, diarrhea and/or constipation, nausea, epigastric pain, gastroesophageal reflux, aphthous stomatitis) and systemic manifestations (tiredness, headache, fibromyalgia-like joint/muscle pain, leg or arm numbness, 'foggy mind,' dermatitis or skin rash, depression, anxiety, and anemia). In the large majority of patients, the time lapse between gluten ingestion and the appearance of symptoms varied from a few hours to 1 day. The most frequent associated disorders were irritable bowel syndrome (47%), food intolerance (35%) and IgE-mediated allergy (22%). An associated autoimmune disease was detected in 14% of cases. Regarding family history, 18% of our patients had a relative with celiac disease, but no correlation was found between NCGS and positivity for HLA-DQ2/-DQ8. IgG anti-gliadin antibodies were detected in 25% of the patients tested. Only a proportion of patients underwent duodenal biopsy; for those that did, the biopsies showed normal intestinal mucosa (69%) or mild increase in intraepithelial lymphocytes (31%). The ratio between suspected NCGS and new CD diagnoses, assessed in 28 of the participating centers, was 1.15 to 1.
This prospective survey shows that NCGS has a strong correlation with female gender and adult age. Based on our results, the prevalence of NCGS seems to be only slightly higher than that of celiac disease.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antibodies</subject><subject>Barley</subject><subject>Celiac disease</subject><subject>Celiac Disease - epidemiology</subject><subject>Cereals</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Comparative analysis</subject><subject>Diagnosis</subject><subject>Diet, Gluten-Free</subject><subject>Female</subject><subject>Food Hypersensitivity - epidemiology</subject><subject>Food Hypersensitivity - etiology</subject><subject>Gastroenterology</subject><subject>Gastrointestinal Diseases - epidemiology</subject><subject>Gastrointestinal Diseases - etiology</subject><subject>Gluten</subject><subject>Glutens - adverse effects</subject><subject>HLA-DQ Antigens - immunology</subject><subject>Humans</subject><subject>Internal medicine</subject><subject>Intestinal Mucosa - immunology</subject><subject>Irritable bowel syndrome</subject><subject>Italy - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nutrition research</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Questionnaires</subject><subject>Sex Factors</subject><subject>Skin diseases</subject><subject>Statistics</subject><subject>Surveys</subject><subject>Surveys and Questionnaires</subject><subject>Young Adult</subject><issn>1741-7015</issn><issn>1741-7015</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp1Uk1r3DAQNaWhSdOeeyuCQm5OJEuypEthG_oRCPTSnoUsj70KtrS15IX995Wz6XYXEgSSePPmMW9miuIDwdeEyPqGCEZKgQkvSVVK_qq4OCCvj_7nxdsYHzCuuBDsTXFeMSk5Ffyi6Fce3SUzOOPRZgpxAza5LaBxHpKz4BNMKM7TFnYoZIZJLmMxQ49MaFHo0Npsne-RD760kJUs6oc5gUcRfHRZzqXdu-KsM0OE90_vZfH729dftz_K-5_f725X92VTY5ZKEFiw1lJQygrMWaOUEpxaoBy3uMOVUtwaZqUyNWksk6JmTEisOmsr1XJ6WXze627mZoR2cTCZQW8mN5ppp4Nx-jTi3Vr3YasZ5rSSNAt82Qs0LrwgcBqxYdRLo_XSaE0qLZcqPj1VMYU_M8SkH8I8-WxcE05lVeeb_Gf1ZgDtfBeyoB1dtHrFqaoJlnjRun6GlU8Lo7PBQ-cyfpJwdZSwBjOkdQx5Ii74eEq82RNtHnycoDu4JFgv6_WMr4_H3T3w_-0T_QuEGsr8</recordid><startdate>20140523</startdate><enddate>20140523</enddate><creator>Volta, Umberto</creator><creator>Bardella, Maria Teresa</creator><creator>Calabrò, Antonino</creator><creator>Troncone, Riccardo</creator><creator>Corazza, Gino Roberto</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope></search><sort><creationdate>20140523</creationdate><title>An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity</title><author>Volta, Umberto ; Bardella, Maria Teresa ; Calabrò, Antonino ; Troncone, Riccardo ; Corazza, Gino Roberto</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b604t-e7074dc3e99c7054b999753ce350d0f02995ca4c89a61bc4876447809fcc29d53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antibodies</topic><topic>Barley</topic><topic>Celiac disease</topic><topic>Celiac Disease - epidemiology</topic><topic>Cereals</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Comparative analysis</topic><topic>Diagnosis</topic><topic>Diet, Gluten-Free</topic><topic>Female</topic><topic>Food Hypersensitivity - epidemiology</topic><topic>Food Hypersensitivity - etiology</topic><topic>Gastroenterology</topic><topic>Gastrointestinal Diseases - epidemiology</topic><topic>Gastrointestinal Diseases - etiology</topic><topic>Gluten</topic><topic>Glutens - adverse effects</topic><topic>HLA-DQ Antigens - immunology</topic><topic>Humans</topic><topic>Internal medicine</topic><topic>Intestinal Mucosa - immunology</topic><topic>Irritable bowel syndrome</topic><topic>Italy - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nutrition research</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Questionnaires</topic><topic>Sex Factors</topic><topic>Skin diseases</topic><topic>Statistics</topic><topic>Surveys</topic><topic>Surveys and Questionnaires</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Volta, Umberto</creatorcontrib><creatorcontrib>Bardella, Maria Teresa</creatorcontrib><creatorcontrib>Calabrò, Antonino</creatorcontrib><creatorcontrib>Troncone, Riccardo</creatorcontrib><creatorcontrib>Corazza, Gino Roberto</creatorcontrib><creatorcontrib>Study Group for Non-Celiac Gluten Sensitivity</creatorcontrib><creatorcontrib>The Study Group for Non-Celiac Gluten Sensitivity</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMC medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Volta, Umberto</au><au>Bardella, Maria Teresa</au><au>Calabrò, Antonino</au><au>Troncone, Riccardo</au><au>Corazza, Gino Roberto</au><aucorp>Study Group for Non-Celiac Gluten Sensitivity</aucorp><aucorp>The Study Group for Non-Celiac Gluten Sensitivity</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity</atitle><jtitle>BMC medicine</jtitle><addtitle>BMC Med</addtitle><date>2014-05-23</date><risdate>2014</risdate><volume>12</volume><issue>1</issue><spage>85</spage><epage>85</epage><pages>85-85</pages><artnum>85</artnum><issn>1741-7015</issn><eissn>1741-7015</eissn><abstract>Non-celiac gluten sensitivity (NCGS) is still an undefined syndrome with several unsettled issues despite the increasing awareness of its existence. We carried out a prospective survey on NCGS in Italian centers for the diagnosis of gluten-related disorders, with the aim of defining the clinical picture of this new syndrome and to establish roughly its prevalence compared with celiac disease.
From November 2012 to October 2013, 38 Italian centers (27 adult gastroenterology, 5 internal medicine, 4 pediatrics, and 2 allergy) participated in this prospective survey. A questionnaire was used in order to allow uniform and accurate collection of clinical, biochemical, and instrumental data.
In total, 486 patients with suspected NCGS were identified in this 1-year period. The female/male ratio was 5.4 to 1, and the mean age was 38 years (range 3-81). The clinical picture was characterized by combined gastrointestinal (abdominal pain, bloating, diarrhea and/or constipation, nausea, epigastric pain, gastroesophageal reflux, aphthous stomatitis) and systemic manifestations (tiredness, headache, fibromyalgia-like joint/muscle pain, leg or arm numbness, 'foggy mind,' dermatitis or skin rash, depression, anxiety, and anemia). In the large majority of patients, the time lapse between gluten ingestion and the appearance of symptoms varied from a few hours to 1 day. The most frequent associated disorders were irritable bowel syndrome (47%), food intolerance (35%) and IgE-mediated allergy (22%). An associated autoimmune disease was detected in 14% of cases. Regarding family history, 18% of our patients had a relative with celiac disease, but no correlation was found between NCGS and positivity for HLA-DQ2/-DQ8. IgG anti-gliadin antibodies were detected in 25% of the patients tested. Only a proportion of patients underwent duodenal biopsy; for those that did, the biopsies showed normal intestinal mucosa (69%) or mild increase in intraepithelial lymphocytes (31%). The ratio between suspected NCGS and new CD diagnoses, assessed in 28 of the participating centers, was 1.15 to 1.
This prospective survey shows that NCGS has a strong correlation with female gender and adult age. Based on our results, the prevalence of NCGS seems to be only slightly higher than that of celiac disease.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>24885375</pmid><doi>10.1186/1741-7015-12-85</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; Springer Nature OA Free Journals; PubMed Central; SpringerLink Journals - AutoHoldings |
| subjects | Adolescent Adult Age Factors Aged Aged, 80 and over Antibodies Barley Celiac disease Celiac Disease - epidemiology Cereals Child Child, Preschool Comparative analysis Diagnosis Diet, Gluten-Free Female Food Hypersensitivity - epidemiology Food Hypersensitivity - etiology Gastroenterology Gastrointestinal Diseases - epidemiology Gastrointestinal Diseases - etiology Gluten Glutens - adverse effects HLA-DQ Antigens - immunology Humans Internal medicine Intestinal Mucosa - immunology Irritable bowel syndrome Italy - epidemiology Male Middle Aged Nutrition research Patients Pediatrics Prevalence Prospective Studies Questionnaires Sex Factors Skin diseases Statistics Surveys Surveys and Questionnaires Young Adult |
| title | An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity |
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