Document Detail

Non-celiac wheat sensitivity diagnosed by double-blind placebo-controlled challenge: exploring a new clinical entity.
MedLine Citation:
PMID:  22825366     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Non-celiac wheat sensitivity (WS) is considered a new clinical entity. An increasing percentage of the general population avoids gluten ingestion. However, the real existence of this condition is debated and specific markers are lacking. Our aim was thus to demonstrate the existence of WS and define its clinical, serologic, and histological markers.
METHODS: We reviewed the clinical charts of all subjects with an irritable bowel syndrome (IBS)-like presentation who had been diagnosed with WS using a double-blind placebo-controlled (DBPC) challenge in the years 2001-2011. One hundred celiac disease (CD) patients and fifty IBS patients served as controls.
RESULTS: Two hundred and seventy-six patients with WS, as diagnosed by DBPC challenge, were included. Two groups showing distinct clinical characteristics were identified: WS alone (group 1) and WS associated with multiple food hypersensitivity (group 2). As a whole group, the WS patients showed a higher frequency of anemia, weight loss, self-reported wheat intolerance, coexistent atopy, and food allergy in infancy than the IBS controls. There was also a higher frequency of positive serum assays for IgG/IgA anti-gliadin and cytometric basophil activation in "in vitro" assay. The main histology characteristic of WS patients was eosinophil infiltration of the duodenal and colon mucosa. Patients with WS alone were characterized by clinical features very similar to those found in CD patients. Patients with multiple food sensitivity were characterized by clinical features similar to those found in allergic patients.
CONCLUSIONS: Our data confirm the existence of non-celiac WS as a distinct clinical condition. We also suggest the existence of two distinct populations of subjects with WS: one with characteristics more similar to CD and the other with characteristics pointing to food allergy.
Antonio Carroccio; Pasquale Mansueto; Giuseppe Iacono; Maurizio Soresi; Alberto D'Alcamo; Francesca Cavataio; Ignazio Brusca; Ada M Florena; Giuseppe Ambrosiano; Aurelio Seidita; Giuseppe Pirrone; Giovanni Battista Rini
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-07-24
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  107     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-05     Completed Date:  2013-01-28     Revised Date:  2013-12-17    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1898-906; quiz 1907     Citation Subset:  IM    
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MeSH Terms
Anemia, Hypochromic / etiology
Autoantibodies / blood*
Celiac Disease / diagnosis,  immunology
Diagnosis, Differential
Double-Blind Method
Food Hypersensitivity / complications,  diagnosis*,  immunology*
Gliadin / immunology*
Hypersensitivity, Immediate / complications
Immunoglobulin A / blood
Immunoglobulin G / blood
Irritable Bowel Syndrome / diagnosis,  immunology
Middle Aged
Research Design
Risk Factors
Severity of Illness Index
Triticum / immunology*
Weight Loss
Reg. No./Substance:
0/Autoantibodies; 0/Immunoglobulin A; 0/Immunoglobulin G; 9007-90-3/Gliadin
Comment In:
Am J Gastroenterol. 2013 Mar;108(3):451-2   [PMID:  23459051 ]
Am J Gastroenterol. 2013 Mar;108(3):451   [PMID:  23459052 ]
Am J Gastroenterol. 2013 Nov;108(11):1805   [PMID:  24192952 ]
Am J Gastroenterol. 2013 Apr;108(4):620   [PMID:  23552313 ]
Am J Gastroenterol. 2013 Apr;108(4):619-20   [PMID:  23552312 ]
Am J Gastroenterol. 2012 Dec;107(12):1908-12   [PMID:  23211856 ]
Am J Gastroenterol. 2013 Nov;108(11):1805-6   [PMID:  24192953 ]

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