Breifly Noted: Duodenal and Rectal Eosinophilia in Nonceliac Gluten Sensitivity

A Carroccio et al. Clin Gastroenterol Hepatol 2019; 17: 682-90. This prospective study examined 78 patients with a diagnosis of non-celiac gluten sensitivity (NCGS) based on double-blind wheat challenge.  The authors identified markers of inflammation including eosinophils in the duodenum and rectum of patients with NCGS:  –the mean eosinophil infiltration was more than 2.5-fold the upper limit of normal in rectum and almost 2-fold in duodenum.

Rectal eosinophilia (>9 eos in the rectal lamina propria) had a sensitivity of 94%, specificity of 70%, positive predictive value of 81% and negative predictive value of 89% for NCGS.

My take: (from the editorial,pg 613-4) “In many cases, NCGS is likely a mislabeled functional GI disorder (IBS or FD) induced by wheat proteins or FODMAPs…tissue eosinophilia [is a] potential biomarker..although this observation needs further confirmation.”

Yummy! Though, probably the wrong place for those trying to be gluten-free

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