Background: Diagnosing both celiac disease (CD) and wheat allergy (WA) might be challenging due to the increasingly popular gluten-free diets. Objectives: This study investigates the value of anti-tissue transglutaminase IgA (tTGIgA) and wheat-specific IgE (WIgE), and identifies clinical and serological features associated with CD and WA. Method: Serological markers of autoimmunity and allergy along with medical charts of patients assessed for tTGIgA and WIgE between 2010 and 2016 were evaluated. Results: During the last years, an increasing number of patients have been tested for tTGIgA, while the number of positive results decreased linearly. Among the 2,965 patients included, 128 patients showed at least once a positive tTGIgA. All patients with tTGIgA levels higher than the 12-fold upper normal limit had CD. The ratio of tTGIgA/total IgA did not perform better as a diagnostic test for CD compared to tTGIgA. tTGIgA and anti-nuclear antibodies were significantly associated. WA was only rarely investigated, particularly in adults. However, positive WIgE were found in nearly 50% of the cases. WIgE and tTGIgA values were negatively correlated. Conclusions: tTGIgA were increasingly tested, while the rate of positive results decreased in recent years, possibly reflecting the impact of current alimentary trends on clinical practice. Associated autoimmune disease was frequently found in CD. High levels of tTGIgA accurately predicted CD diagnosis. WA was rarely investigated and deserves more attention, in particular in children with atopic background. WA does not seem to be associated with CD.

1.
Molina-Infante
J
,
Santolaria
S
,
Sanders
DS
,
Fernández-Bañares
F
.
Systematic review: noncoeliac gluten sensitivity
.
Aliment Pharmacol Ther
.
2015
May
;
41
(
9
):
807
20
.
[PubMed]
0269-2813
2.
Elli
L
,
Branchi
F
,
Tomba
C
,
Villalta
D
,
Norsa
L
,
Ferretti
F
, et al
Diagnosis of gluten related disorders: celiac disease, wheat allergy and non-celiac gluten sensitivity
.
World J Gastroenterol
.
2015
Jun
;
21
(
23
):
7110
9
.
[PubMed]
1007-9327
3.
Catassi
C
,
Gatti
S
,
Lionetti
E
.
World perspective and celiac disease epidemiology
.
Dig Dis
.
2015
;
33
(
2
):
141
6
.
[PubMed]
0257-2753
4.
Riddle
MS
,
Murray
JA
,
Porter
CK
.
The incidence and risk of celiac disease in a healthy US adult population
.
Am J Gastroenterol
.
2012
Aug
;
107
(
8
):
1248
55
.
[PubMed]
0002-9270
5.
Turner
JM
.
Diagnosis of Celiac Disease: Taking a Bite Out of the Controversy
.
Dig Dis Sci
.
2018
Jun
;
63
(
6
):
1384
91
.
[PubMed]
0163-2116
6.
Venter
C
,
Maslin
K
,
Arshad
SH
,
Patil
V
,
Grundy
J
,
Glasbey
G
, et al
Very low prevalence of IgE mediated wheat allergy and high levels of cross-sensitisation between grass and wheat in a UK birth cohort
.
Clin Transl Allergy
.
2016
Jun
;
6
(
1
):
22
.
[PubMed]
2045-7022
7.
Lebwohl
B
,
Cao
Y
,
Zong
G
,
Hu
FB
,
Green
PH
,
Neugut
AI
, et al
Long term gluten consumption in adults without celiac disease and risk of coronary heart disease: prospective cohort study
.
BMJ
.
2017
May
;
357
:
j1892
.
[PubMed]
0959-8138
8.
Scherf
KA
,
Brockow
K
,
Biedermann
T
,
Koehler
P
,
Wieser
H
.
Wheat-dependent exercise-induced anaphylaxis
.
Clin Exp Allergy
.
2016
Jan
;
46
(
1
):
10
20
.
[PubMed]
0954-7894
9.
Morita
E
,
Matsuo
H
,
Chinuki
Y
,
Takahashi
H
,
Dahlström
J
,
Tanaka
A
.
Food-dependent exercise-induced anaphylaxis -importance of omega-5 gliadin and HMW-glutenin as causative antigens for wheat-dependent exercise-induced anaphylaxis-
.
Allergol Int
.
2009
Dec
;
58
(
4
):
493
8
.
[PubMed]
1323-8930
10.
Weichel
M
,
Vergoossen
NJ
,
Bonomi
S
,
Scibilia
J
,
Ortolani
C
,
Ballmer-Weber
BK
, et al
Screening the allergenic repertoires of wheat and maize with sera from double-blind, placebo-controlled food challenge positive patients
.
Allergy
.
2006
Jan
;
61
(
1
):
128
35
.
[PubMed]
0105-4538
11.
Lebwohl
B
,
Ludvigsson
JF
,
Green
PH
.
Celiac disease and non-celiac gluten sensitivity.
BMJ
2015
;351h4347.
12.
Leonard
MM
,
Sapone
A
,
Catassi
C
,
Fasano
A
.
Celiac Disease and Nonceliac Gluten Sensitivity: A Review
.
JAMA
.
2017
Aug
;
318
(
7
):
647
56
.
[PubMed]
0098-7484
13.
Carroccio
A
,
D'Alcamo
A
,
Cavataio
F
,
Soresi
M
,
Seidita
A
,
Sciume
C
, et al
High Proportions of People With Nonceliac Wheat Sensitivity Have Autoimmune Disease or Antinuclear Antibodies.
Gastroenterology
2015
;149(3):596-603 e1.
14.
Di Tola
M
,
Marino
M
,
Goetze
S
,
Casale
R
,
Di Nardi
S
,
Borghini
R
, et al
Identification of a serum transglutaminase threshold value for the noninvasive diagnosis of symptomatic adult celiac disease patients: a retrospective study
.
J Gastroenterol
.
2016
Nov
;
51
(
11
):
1031
9
.
[PubMed]
0944-1174
15.
Zanini
B
,
Lanzarotto
F
,
Mora
A
,
Bertolazzi
S
,
Turini
D
,
Cesana
B
, et al
Five year time course of celiac disease serology during gluten free diet: results of a community based “CD-Watch” program
.
Dig Liver Dis
.
2010
Dec
;
42
(
12
):
865
70
.
[PubMed]
1590-8658
16.
Sun
X
,
Lu
L
,
Yang
R
,
Li
Y
,
Shan
L
,
Wang
Y
.
Increased Incidence of Thyroid Disease in Patients with Celiac Disease: A Systematic Review and Meta-Analysis
.
PLoS One
.
2016
Dec
;
11
(
12
):
e0168708
.
[PubMed]
1932-6203
17.
Spadaccino
AC
,
Basso
D
,
Chiarelli
S
,
Albergoni
MP
,
D’Odorico
A
,
Plebani
M
, et al
Celiac disease in North Italian patients with autoimmune thyroid diseases
.
Autoimmunity
.
2008
Feb
;
41
(
1
):
116
21
.
[PubMed]
0891-6934
18.
Zali
MR
,
Rostami Nejad
M
,
Rostami
K
,
Alavian
SM
.
Liver complications in celiac disease
.
Hepat Mon
.
2011
May
;
11
(
5
):
333
41
.
[PubMed]
1735-3408
19.
Bizzaro
N
,
Villalta
D
,
Tonutti
E
,
Tampoia
M
,
Bassetti
D
,
Tozzoli
R
.
Association of celiac disease with connective tissue diseases and autoimmune diseases of the digestive tract
.
Autoimmun Rev
.
2003
Oct
;
2
(
6
):
358
63
.
[PubMed]
1568-9972
20.
Bibbò
S
,
Pes
GM
,
Usai-Satta
P
,
Salis
R
,
Soro
S
,
Quarta Colosso
BM
, et al
Chronic autoimmune disorders are increased in coeliac disease: A case-control study
.
Medicine (Baltimore)
.
2017
Nov
;
96
(
47
):
e8562
.
[PubMed]
0025-7974
21.
Pallav
K
,
Xu
H
,
Leffler
DA
,
Kabbani
T
,
Kelly
CP
.
Immunoglobulin A deficiency in celiac disease in the United States
.
J Gastroenterol Hepatol
.
2016
Jan
;
31
(
1
):
133
7
.
[PubMed]
0815-9319
22.
Rubio-Tapia
A
,
Hill
ID
,
Kelly
CP
,
Calderwood
AH
,
Murray
JA
;
American College of Gastroenterology
.
ACG clinical guidelines: diagnosis and management of celiac disease
.
Am J Gastroenterol
.
2013
May
;
108
(
5
):
656
76
.
[PubMed]
0002-9270
23.
de Chaisemartin
L
,
Meatchi
T
,
Malamut
G
,
Fernani-Oukil
F
,
Hosking
F
,
Rault
D
, et al
Application of Deamidated Gliadin Antibodies in the Follow-Up of Treated Celiac Disease
.
PLoS One
.
2015
Aug
;
10
(
8
):
e0136745
.
[PubMed]
1932-6203
24.
Husby
S
,
Koletzko
S
,
Korponay-Szabó
IR
,
Mearin
ML
,
Phillips
A
,
Shamir
R
, et al;
ESPGHAN Working Group on Coeliac Disease Diagnosis
;
ESPGHAN Gastroenterology Committee
;
European Society for Pediatric Gastroenterology, Hepatology, and Nutrition
.
European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease
.
J Pediatr Gastroenterol Nutr
.
2012
Jan
;
54
(
1
):
136
60
.
[PubMed]
0277-2116
25.
Ludvigsson
JF
,
Bai
JC
,
Biagi
F
,
Card
TR
,
Ciacci
C
,
Ciclitira
PJ
, et al;
BSG Coeliac Disease Guidelines Development Group
;
British Society of Gastroenterology
.
Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology
.
Gut
.
2014
Aug
;
63
(
8
):
1210
28
.
[PubMed]
0017-5749
26.
Sampson
HA
,
Aceves
S
,
Bock
SA
,
James
J
,
Jones
S
,
Lang
D
, et al;
Joint Task Force on Practice Parameters
;
Practice Parameter Workgroup
.
Food allergy: a practice parameter update-2014
.
J Allergy Clin Immunol
.
2014
Nov
;
134
(
5
):
1016
25.e43
.
[PubMed]
0091-6749
27.
Werkstetter
KJ
,
Korponay-Szabó
IR
,
Popp
A
,
Villanacci
V
,
Salemme
M
,
Heilig
G
, et al;
ProCeDE study group
.
Accuracy in Diagnosis of Celiac Disease Without Biopsies in Clinical Practice
.
Gastroenterology
.
2017
Oct
;
153
(
4
):
924
35
.
[PubMed]
0016-5085
28.
Wolf
J
,
Petroff
D
,
Richter
T
,
Auth
MKH
,
Uhlig
HH
,
Laass
MW
, et al
Validation of Antibody-Based Strategies for Diagnosis of Pediatric Celiac Disease Without Biopsy.
Gastroenterology
2017
;153(2):410-9 e17.
29.
Singh
K
,
Chang
C
,
Gershwin
ME
.
IgA deficiency and autoimmunity
.
Autoimmun Rev
.
2014
Feb
;
13
(
2
):
163
77
.
[PubMed]
1568-9972
30.
Maglio
M
,
Tosco
A
,
Paparo
F
,
Auricchio
R
,
Granata
V
,
Colicchio
B
, et al
Serum and intestinal celiac disease-associated antibodies in children with celiac disease younger than 2 years of age
.
J Pediatr Gastroenterol Nutr
.
2010
Jan
;
50
(
1
):
43
8
.
[PubMed]
0277-2116
31.
Panetta
F
,
Torre
G
,
Colistro
F
,
Ferretti
F
,
Daniele
A
,
Diamanti
A
.
Clinical accuracy of anti-tissue transglutaminase as screening test for celiac disease under 2 years
.
Acta Paediatr
.
2011
May
;
100
(
5
):
728
31
.
[PubMed]
0803-5253
32.
Savage
J
,
Johns
CB
.
Food allergy: epidemiology and natural history
.
Immunol Allergy Clin North Am
.
2015
Feb
;
35
(
1
):
45
59
.
[PubMed]
0889-8561
33.
Kelly
C
,
Gangur
V
.
Sex Disparity in Food Allergy: Evidence from the PubMed Database
.
J Allergy (Cairo)
.
2009
;
2009
:
159845
.
[PubMed]
1687-9783
34.
Enroth
S
,
Dahlbom
I
,
Hansson
T
,
Johansson
Å
,
Gyllensten
U
.
Prevalence and sensitization of atopic allergy and coeliac disease in the Northern Sweden Population Health Study
.
Int J Circumpolar Health
.
2013
Aug
;
72
(
1
):
72
.
[PubMed]
1239-9736
35.
Greco
L
,
De Seta
L
,
D’Adamo
G
,
Baldassarre
C
,
Mayer
M
,
Siani
P
, et al
Atopy and coeliac disease: bias or true relation?
Acta Paediatr Scand
.
1990
Jun-Jul
;
79
(
6-7
):
670
4
.
[PubMed]
0001-656X
36.
Pillon
R
,
Ziberna
F
,
Badina
L
,
Ventura
A
,
Longo
G
,
Quaglia
S
, et al
Prevalence of celiac disease in patients with severe food allergy
.
Allergy
.
2015
Oct
;
70
(
10
):
1346
9
.
[PubMed]
0105-4538
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