Anti-gliadin antibodies are seen in: September 2008
Ans. D: Celiac disease Celiac sprue/celiac disease/gluten-sensitive enteropathy is a chronic disease of the digestive tract that interferes with the digestion and absorption of food nutrients. People with celiac sprue cannot tolerate gliadin, the alcohol-soluble fraction of gluten. Gluten is a protein commonly found in wheat, rye, and barley. Most patients with celiac disease tolerate oats, but they should be monitored closely. When people with celiac sprue ingest gliadin, the mucosa of their intestines is damaged by an immunologically mediated inflammatory response, resulting in maldigestion and malabsorption. Patients with celiac disease can present with failure to thrive and diarrhea (the classical form). However, some patients have only subtle symptoms (atypical celiac disease) or are asymptomatic (silent celiac disease). Blood for specific screening tests should be drawn before the patient is placed on a gluten-free diet. Current screening tests include IgA antibodies to tissue transaminase, IgA/IgG antigliadin antibodies and IgA antiendomysial antibody. Combined presence of antiendomysial antibody and antigliadin antibody is almost predictive of intestinal mucosal atrophy but if both antibody tests are negative, mucosa is almost normal. Antiendomysial antibody screening is an excellent test for the diagnosis and follow-up of celiac disease and for identification of asymptomatic patients. Antiendomysial antibodies are highly specific but less sensitive than other antibodies. The absence of HLA-DQ2 or HLA-DQ8 is useful for its high negative predictive value, but they are not helpful in confirming the diagnosis. Individuals with celiac disease have a higher than normal rate of malignancy. The most common celiac disease associated malignancy is enteropathy-associated T-cell lymphoma and small intestinal adenocarcinoma.
Tropical sprue
Ulcerative colitis
Crohn disease
Ceeliac disease