[Class IgA antigliadin antibodies and monitoring of compliance to gluten-free diet in celiac disease]. / Anticorpi antigliadina di classe IgA e monitoraggio della compliance alla dieta aglutinata nella malattia celiaca.

Antibodies to gliadin (AGA), detected by ELISA, were found in the sera of 37 (88%) of 42 patients with untreated adult celiac disease. IgG class AGA showed a higher sensitivity for the diagnosis of celiac disease than IgA AGA, but, while IgA AGA had a specificity of 100% for celiac disease, false positives of IgG class were present in 19% of 37 patients with ulcerative colitis and in 27% of 26 patients with Crohn's disease. Twenty-eight out of our 42 adult celiac patients were tested after 6-12 months of gluten free diet: IgG AGA persisted in 43% of them showing antibody titres lower than those observed in untreated celiac disease. IgA AGA became negative after gluten withdrawal and there was regrowth of jejunal villi in all but 2 adult celiac patients (7%), who continued to present IgA AGA positivity and subtotal villous atrophy. These 2 patients did not comply to the gluten free diet. Our study confirms the specificity of IgA AGA for untreated celiac disease and emphasizes their usefulness in monitoring the compliance with gluten free diet in adult celiac disease.

Different course of acute hepatitis B in elderly adults.

A retrospective study on 50 young and 35 aged patients with acute hepatitis B was performed. Clinical and laboratory parameters were evaluated. The most significant results obtained in the aged group when compared with the young were longer hospitalization, less elevated serum glutamic-pyruvic transaminase, serum bilirubin and alkaline phosphatase significantly higher, lower IgM and higher IgA levels. The results indicate that acute hepatitis B in elderly adults is characterized by a milder liver cell necrosis and a hypercholestatic pattern. The possible causes for these features are discussed.