Gluten-related disorders are divided into three categories based on their pathogenic mechanism: autoimmune, allergic, and non-autoimmune non-allergic. Comprehensive testing of gluten-related disorders at Diagnostiki Athinon includes investigation of all three categories, i.e., screening for celiac disease, wheat allergy, and gluten intolerance.
Autoimmune Disorders
Autoimmune disorders occur weeks to years after gluten exposure. Autoimmune disorders include celiac disease, dermatitis herpetiformis, and gluten ataxia.
Celiac disease
Celiac disease is an immune-mediated enteropathy caused by gluten consumption in sensitive individuals. The onset of symptoms is usually gradual and is characterized by a period of months or years after gluten introduction. However, in patients on long-term treatment with a gluten-free diet, gluten foods can occasionally cause immediate symptoms, such as vomiting and abdominal pain.
Dermatitis Herpetiformis
Dermatitis herpetiformis is a pathological manifestation of the skin in patients with celiac disease. It presents as a vesicular rash, and histologically, there are deposits of immunoglobulin IgA in the skin.
Gluten Ataxia
Gluten ataxia was initially defined as idiopathic sporadic ataxia with positive serum biomarkers of gluten intolerance. Like celiac disease, it is an autoimmune disease characterized by damage to the cerebellum, leading to ataxia, a lack of muscle coordination in voluntary movements.
Allergic Disorders (Wheat Allergy)
Allergic reactions occur minutes to hours after exposure to gluten.
Wheat allergy is defined as an adverse immune response to wheat proteins. Depending on the allergen exposure route and underlying immune mechanisms, wheat allergy is classified as a classical food allergy that affects the skin, gastrointestinal or respiratory tract, wheat-dependent exercise-induced anaphylaxis (WDEIA), professional asthma (baker's asthma), rhinitis, and contact urticaria. The IgE antibodies play a central role in the pathogenesis of these diseases.
Non-Autoimmune Non-Allergic disorders (Gluten Sensitivity)
Non-autoimmune & non-allergic reactions occur hours to days after exposure to gluten.
It is now clear that, in addition to celiac disease and wheat allergy, there are cases of reactions to gluten in which allergic or autoimmune mechanisms cannot be identified. These cases are generally defined as Non-Celiac Sensitivity to Gluten (NCGS) or gluten sensitivity.
Gluten sensitivity is a condition different from celiac disease and is not accompanied by an increase of anti-tTG (tissue transglutaminase) autoantibodies or the presence of other autoimmune conditions. The small intestine of patients with gluten sensitivity is usually expected. However, the two pathological conditions cannot be distinguished clinically, as the symptoms experienced by patients with gluten sensitivity often occur also in patients with celiac disease.
Who benefits from Gluten Sensitivity Testing Comprehensive Profile?
This test is for adults who have any of the symptoms of gluten intolerance and whose gluten-free diet reduces or eliminates symptoms.
See also
- Deamidated Gliadin Peptides (DGP), IgA Antibodies
- Deamidated Gliadin Peptides (DGP), IgG Antibodies
- Endomysial Antibodies IgA, Serum
- Endomysial Antibodies IgG, Serum
- Tissue Transglutaminase (tTG), IgA Antibodies
- Tissue Transglutaminase (tTG), IgG Antibodies
- Celiac Disease, Genetic Testing
- Celiac Disease, Basic Profile
- Celiac Disease, Extended Profile
