Prasad, S., Thomas, P., Nicholas, D. S., Sharer, N.M. and Snook, J. A., 2001. Adult endomysial antibody-negative coeliac disease and cigarette smoking. European Journal of Gastroenterology & Hepatology, 13 (6), pp. 667-671.
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Official URL: http://www.eurojgh.com/pt/re/ejgh/abstract.0004273...
Objective: To determine the relative incidence and characteristics of endomysial antibody (EMA)-negative coeliac disease in adults. Design: Retrospective analysis of prospectively collected data on adults with newly diagnosed coeliac disease, with determination of EMA status before gluten withdrawal. Setting: District general hospital (secondary care institution). Participants: Sixty consecutive incident cases. Main outcome measures: (i) Proportion of cases who were EMA-negative; (ii) comparison of clinical and laboratory variables at diagnosis for EMA-positive and EMA-negative subjects. Results: Fifteen subjects (25%, 95% CI 15-38%) were EMA negative, of whom only two were IgA deficient. There was clinical evidence in all 15 patients and histological evidence in 13 patients of a response to gluten withdrawal. No significant differences were found between EMA-positive and EMA-negative subjects with respect to histological features, age, gender, clinical manifestations, concurrent autoimmune disorders, family history of coeliac disease, or haemoglobin and albumin concentrations at diagnosis. However, EMA-negative status at diagnosis was associated strongly with current or recent cigarette smoking (OR 7.0, 95% CI 1.7-31.5, P = 0.003). Conclusions: A substantial minority of patients with otherwise typical coeliac disease are EMA negative, and most of these are IgA replete. The value of EMA as a screening tool is therefore limited. EMA status in untreated coeliac disease correlates strongly with cigarette smoking history: this may be of pathogenic significance, given the previously demonstrated association between smoking and the risk of coeliac disease.
|Subjects:||Technology > Medicine and Health > Medicine and Surgery|
|Group:||School of Health and Social Care > Centre for Social Work and Social Policy|
|Deposited By:||INVALID USER|
|Deposited On:||02 May 2007|
|Last Modified:||07 Mar 2013 14:37|
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