Behavior of celiac disease serology during gluten free diet [Andamento dei marcatori sierologici della malattia celiaca nella dieta priva di glutine]

Background. Actually, the guidelines are not clear about monitoring of patients with celiac disease (CD) on gluten free-diet (GFD) and sensitivity and accuracy of CD-specific serology as an outcome measurement tool have not been well established and continue to be debated. In the present study we describe the changes of anti tissue-transglutaminase antibodies (t-TG), anti-gliadin antibodies (AGA) and endomysial antibodies (EMA) over time in diagnosed CD patients placed on the GFD to determine which of these markers is a valuable complement for monitoring of GFD. Methods. We selected 44 CD patients on gluten-free diets in which have been assessed at the time of diagnosis, 6 months, 12 months and 2 years after dietary restriction IgA and IgG a-tTG, IgA and IgG AGA and IgA EMA. Results. After 6 months GFD treatment the percentage of positive patients was: 54% for IgA a-tTG, 38% for IgG a-tTG, 47% for EMA, 30% for IgA AGA, 56% for IgG AGA. After 12 months GFD treatment the percentage of positive patients was: 36% for IgA a-tTG, 14% for IgG a-tTG, 9% for EMA, 21% for IgA AGA and 23% for IgG AGA. After 24 months GFD treatment all patients were negative for EMA, IgA AGA and IgG AGA, while 3% and 5% were respectively positive for IgA a-tTG IgA e IgG a-tTG. Conclusions. The effect of treatment was evident as early as 6 months after patients started treatment, but not all CD markers had the same performance. On the basis of obtained results we suggest for monitoring of CD patients on GFD the only determination of a-tTG.