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Advances Aid Treatment, Diagnosis of Celiac Disease
Date:5/19/2008

Leffler, clinical research director at the Celiac Disease Center at Beth Israel Deaconess Medical Center in Boston, said in a prepared statement.

"This work offers great promise for patients who, in the near future, may have a treatment that improves upon dietary restrictions alone," Leffler added.

A second study concluded that the criteria for diagnosing celiac disease may be too stringent, meaning some patients go undiagnosed and, therefore, untreated. Current diagnostic criteria for celiac disease include small intestinal muscosal membrane villus atrophy and inflammation.

This study included 145 people suspected of having celiac disease. Of those, 71 were found to be endomysial antibody positive. Of those 71, 48 met the current criteria for celiac disease diagnosis. The other 23 patients were randomly divided into two groups -- one group ate a regular diet, while the other ate a gluten-free diet. They were re-assessed after one year.

The patients on the gluten-free diet were asymptomatic and had no endomysial antibodies or small intestine mucosal inflammation. The patients on the regular diet continued to have symptoms, were endomysial antibody positive, and had further deterioration of the small intestine membrane, inflammation and gluten-induced lesions in the bowel.

The patients on the regular diet decided to eliminate gluten from their diet and, over time, became symptom-free, endomysial antibody-free, and showed healing of the mucosal membrane.

Some people who are endomysial antibody positive may develop the intestinal damage that makes up the current criteria for diagnosing celiac disease, the researchers said.

"By redefining the criteria for celiac disease, we can treat patients before they begin to experience the most severe symptoms and signs of the disease," study author Dr. Markku Maki, professor of pediatrics at the University of Tampere, Celiac Disease Study Group, in Tampere, Fin
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