Jump to content
This site uses cookies. Continued use is acceptance of our Terms of Use and Privacy Policy. More Info... ×
  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.




  • Celiac.com Sponsor (A1):



    Celiac.com Sponsor (A1-M):


  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate
  • Record is Archived

    This article is now archived and is closed to further replies.

    Jefferson Adams
    Jefferson Adams

    How Do We Tell Celiac Disease from Non-Celiac Gluten Sensitivity?

    Reviewed and edited by a celiac disease expert.

    Celiac.com 06/16/2014 - Differentiating between celiac disease and non-celiac gluten sensitivity (NCGS) is important for appropriate treatment, but is often challenging.

    Photo: Wikimedia Commons--Igreja de CampahaA team of researchers recently set out to assess the best way to distinguish between celiac disease and non-gluten sensitivity. The research team included Toufic A Kabbani, Rohini R Vanga, Daniel A Leffler, Javier Villafuerte-Galvez, Kumar Pallav, Joshua Hansen, Rupa Mukherjee, Melinda Dennis and Ciaran P Kelly.

    Celiac.com Sponsor (A12):
    For their study, the team reviewed records for 238 patients who were assessed for symptoms responsive to gluten restriction without having celiac disease ruled in or out. For each patient, clinicians noted the demographic information, presenting symptoms, serologic, genetic, and histologic data, nutrient deficiencies, personal history of autoimmune diseases, and family history of celiac disease.

    They define NCGS as symptoms responsive to a gluten-free diet, together with negative celiac blood tests and negative duodenal biopsies while on a gluten-containing diet, or negative human leukocyte antigen (HLA) DQ2/DQ8 testing. Of the 238 patients in the study, 101 had celiac disease, 125 had NCGS, 9 had non-celiac enteropathy, and 3 remained undetermined. Nearly 70% of celiac disease subjects suffered symptoms of malabsorption compared with just under 25% of the NCGS subjects (P<0.0001).

    In addition, the patients with celiac disease were far more likely to have a family history of celiac disease (P=0.004), personal history of autoimmune diseases (P=0.002), or nutrient deficiencies (P<0.0001).

    The positive likelihood ratio for celiac disease diagnosis of a >2× upper limit of normal IgA trans-glutaminase antibody (tTG) or IgA/IgG deaminated gliadan peptide antibody (DGP) with clinical response to a gluten-free diet was 130 (confidence interval (CI): 18.5–918.3).

    The positive likelihood ratio of the combination of gluten-responsive symptoms and negative IgA tTG or IgA/IgG DGP on a regular diet for NCGS was 9.6 (CI: 5.5–16.9).

    When individuals with negative IgA tTG or IgA/IgG DGP also lacked symptoms of malabsorption (weight loss, diarrhea, and nutrient deficiencies) and celiac disease risk factors (personal history of autoimmune diseases and family history of celiac disease), the positive likelihood ratio for NCGS increased to 80.9.

    Based on their findings, the team developed a diagnostic algorithm to distinguish celiac disease from NCGS.

    People with negative celiac blood tests (IgA tTG or IgA/IgG DGP, who are eating a regular gluten-containing diet, are unlikely to have celiac disease.

    Those with negative serology who show no clinical signs of malabsorption, and show no celiac disease risk factors, are highly likely to have NCGS and may not require further testing. Those with positive blood tests should undergo HLA typing to determine the need for biopsy.

    Source:

    • Open Original Shared Link


    User Feedback

    Recommended Comments

    Guest Alan

    Interesting article although the opening paragraph is puzzling. All that I have seen indicates that the treatment for celiac disease and NCGS is the same, i.e., a gluten free diet.

    Link to comment
    Share on other sites


    Guest
    This is now closed for further comments

  • Get Celiac.com Updates:
    Support Celiac.com:
    Donate
  • About Me

    Jefferson Adams

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University. His articles, essays, poems, stories and book reviews have appeared in numerous magazines, journals, and websites, including North American Project, Antioch Review, Caliban, Mississippi Review, Slate, and more. He is the author of more than 2,500 articles on celiac disease. His university coursework includes studies in science, scientific methodology, biology, anatomy, physiology, medicine, logic, and advanced research. He previously devised health and medical content for Colgate, Dove, Pfizer, Sharecare, Walgreens, and more. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of numerous books, including "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

    >VIEW ALL ARTICLES BY JEFFERSON ADAMS

     


  • Celiac.com Sponsor (A17):
    Celiac.com Sponsor (A17):





    Celiac.com Sponsors (A17-M):




  • Related Articles

    Jefferson Adams
    Celiac.com 03/30/2011 - A team of medical researchers set out to compare gut permeability and mucosal immune gene expression in celiac disease and gluten sensitivity.
    The research team included Anna Sapone, Karen M Lammers, Vincenzo Casolaro, Marcella Cammarota, Maria T Giuliano, Mario De Rosa, Rosita Stefanile, Giuseppe Mazzarella, Carlo Tolone, Maria I Russo, Pasquale Esposito, Franca Ferraraccio, Maria Carteni, Gabriele Riegler, Laura de Magistris  and Alessio Fasano.
    People with celiac disease suffer an adverse autoimmune reaction when they consume gluten. People with gluten-sensitivity cannot tolerate gluten and may develop gastrointestinal symptoms similar to those in celiac disease.
    However, for people with gluten intolerance, the overall clinical picture is usually less ...


    Jefferson Adams
    Celiac.com 05/14/2012 - Should gluten sensitivity be thought of as “celiac light,” as just one of the milder manifestations within the wider spectrum of celiac disease? Some doctors and researchers think so.
    Over the past several years, there has been increasing discussion concerning gluten sensitivity as a possible cause of irritable bowel syndrome (IBS) symptoms in patients for whom celiac disease has been excluded. 
    This is undoubtedly because gluten sensitivity, like IBS, is a symptom-based condition of diverse pathogenesis. As discussed, some have argued that gluten sensitivity might be best thought of as “celiac light,” representing the milder domains of the celiac disease spectrum.
    However, there are some data to suggest that a subset of patients with gluten sensitiv...


    Jefferson Adams
    Celiac.com 06/13/2012 - In general, doctors and researchers know a good deal about how celiac disease works, and they are finding out more all the time. However, they know very little about non-celiac gluten sensitivity (NCGS).
    In an effort to learn more about non-celiac gluten sensitivity, a team of researchers recently carried out a study to measure the presence of somatization, personality traits, anxiety, depression, and health-related quality of life in NCGS individuals, and to compare the results with celiac disease patients and healthy control subjects. They also compared the response to gluten challenge between patients with non-celiac gluten sensitivity and those with celiac disease.
    The research team included M. Brottveit, P.O. Vandvik, S. Wojniusz, A. Løvik, K.E. Lundin,...


    Jefferson Adams
    Blood Tests Different in Patients with Gluten Sensitivity Than in Those with Celiac Disease
    Celiac.com 12/03/2012 - Gluten sensitivity has recently been added to the spectrum of gluten-related disorders, but precise diagnostic markers do not yet exist. A research team recently set out to understand the blood test pattern of gluten sensitivity, and to compare it with the blood test pattern seen in celiac disease.
    The researchers included U. Volta, F. Tovoli, R. Cicola, C. Parisi, A. Fabbri, M. Piscaglia, E. Fiorini, G. Caio, of the Department of Clinical Medicine at University of Bologna's St. Orsola-Malpighi Hospital in Bologna, Italy.
    For their study, the researchers looked at blood samples from 78 patients with gluten-sensitivity and 80 patients with celiac disease. They assessed levels of immunoglobulin (Ig)G/IgA antigliadin antibodies (AGA), IgG deamidated gliadin peptide...


  • Recent Activity

    1. - Wheatwacked replied to Rosyjo11's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      6

      Has anyone found Ozempic affected their symptoms?

    2. - Wheatwacked replied to Kathleen JJ's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      6

      Options - 7 year old boy - Helicobacter pylori and serology

    3. - Wheatwacked replied to MHavoc's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      1

      On the cusp of facing a new life of managing a life with Celiac Disease

    4. - MHavoc posted a topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      1

      On the cusp of facing a new life of managing a life with Celiac Disease

    5. - Vozzyv posted a topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      0

      Weird Symptoms


  • Celiac.com Sponsor (A19):



  • Member Statistics

    • Total Members
      126,078
    • Most Online (within 30 mins)
      7,748

    AmyCatherine
    Newest Member
    AmyCatherine
    Joined

  • Celiac.com Sponsor (A20):


  • Forum Statistics

    • Total Topics
      120.9k
    • Total Posts
      69.2k

  • Celiac.com Sponsor (A22):





  • Celiac.com Sponsor (A21):



  • Popular Now

    • Kathleen JJ
    • Captain173
      10
    • jjiillee
      7
    • Kristina12
      7
    • StaciField
  • Popular Articles

    • Scott Adams
    • Scott Adams
    • Scott Adams
    • Scott Adams
    • Scott Adams
  • Upcoming Events

×
×
  • Create New...