Document Detail


Five year time course of celiac disease serology during gluten free diet: results of a community based "CD-Watch" program.
MedLine Citation:
PMID:  20598661     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Little information is available on the effect of a follow-up strategy in celiac disease patients during gluten-free diet.
AIMS: To assess 5 year time course of t-transglutaminase antibodies (t-TG) in celiac disease patients enrolled in a community based follow-up program.
METHODS: Annual t-TG testing and periodical clinic visit in 2245 patients.
RESULTS: Proportion of patients with negative t-TG progressively increased from 83% to 93% during the 5-year follow-up: poor adherence to gluten-free diet (HR 4.764), long duration of gluten-free diet (HR 0.929) and female gender (HR 1.472) were independently associated with serological outcome. In individual patients, 69% tested t-TG "persistently negative", 1% "persistently positive" and 30% "intermittently negative or positive". By applying mathematical modelling to t-TG conversion rates observed in this latter group at beginning and end of the follow-up program, the predicted proportion of t-TG negative population increased from 90% to 95% over 5 years.
CONCLUSIONS: Time-course of t-TG serology in the community fluctuates in 1/3 of celiac disease patients suggesting inconstant adherence to gluten-free diet and need of follow-up strategy. Periodical serological and clinical follow-up is a viable and efficacious strategy to promote adherence to gluten-free diet as inferred from time-course of t-TG serology.
Authors:
Barbara Zanini; Francesco Lanzarotto; Alessandra Mora; Stefania Bertolazzi; Daniele Turini; Bruno Cesana; Francesco Donato; Chiara Ricci; Fulvio Lonati; Francesco Vassallo; Carmelo Scarcella; Alberto Lanzini
Publication Detail:
Type:  Journal Article     Date:  2010-07-02
Journal Detail:
Title:  Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver     Volume:  42     ISSN:  1878-3562     ISO Abbreviation:  Dig Liver Dis     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100958385     Medline TA:  Dig Liver Dis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  865-70     Citation Subset:  IM    
Copyright Information:
Copyright © 2010. Published by Elsevier Ltd.
Affiliation:
Gastroenterology Unit, University and Spedali Civili of Brescia, Italy.
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