Finally, researchers are getting down to the nitty-gritty, and pointing out that the classic diagnostic requirements for celiac disease, need to be changed. They still have a way to go, since they still want to hang onto the obsolete blood tests, but at least they're beginning to see the light, and they're pointing out some of the problems with the current diagnostic program.
In this research report, published in the March, 2009 issue of Gastroenterology, researchers discuss how they investigated whether or not patients with positive serology, but negative small intestinal biopsies, should be encouraged to follow the GF diet for the rest of their lives. Interestingly, the SI biopsies showed inflammation, but no villus attrophy, for this group of patients. They found that, typically, reactions were just as severe for this group, as for celiacs who met the classic standards, (that is, with both positive serology tests, and biopsies showing villus atrophy). IOW, this finding suggests that small intestinal inflammation, (together with the presence of anti-endomysial antibodies), should be sufficient for a diagnosis of celiac disease, (of course, they didn't come right out and say that, but it's obviously inferred).
Also, IMO, the choice of wording shown in the phrase that I've emphasized in red, is very, very important, since it recognizes the existence of a spectrum or gluten sensitivity, just as we've always maintained, (and which Dr. Fine proposed over a decade ago).Conclusions
Patients with endomysial antibodies benefit from a GFD regardless of the degree of enteropathy. The diagnostic criteria for celiac disease need re-evaluation: endomysial antibody positivity without atrophy belongs to the spectrum of genetic gluten intolerance, and warrants dietary treatment.
Note that this research also validates what Dr. Fine claimed years ago, namely that celiac disease can be reliably detected much earlier than the classic celiac diagnostic standards allow, thus allowing those patients to preempt unnecessary years of suffering from intestinal damage, while waiting for the damage to become severe enough to allow a diagnosis by means of classic celiac standards, (of course, they didn't bother to mention that, either
http://www.sciencedirect.com/science?_o ... 751fc1fe3c
I'm guessing that Dr. Fine probably cited this research in his own recently-submitted article, to add substance to his previous findings. In fact, this research report may be what inspired him to rewrite and resubmit his article, again, after a hiatus of several years. If he didn't cite this reference, he certainly missed a good bet.
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