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Copyright ©The Author(s) 2017.
World J Gastroenterol. Oct 28, 2017; 23(40): 7201-7210
Published online Oct 28, 2017. doi: 10.3748/wjg.v23.i40.7201
Table 1 Comparison of gluten related disorders[34,51-72]
NCGSCDIBSWA
Colonic manifestationsDiarrheaDiarrheaDiarrheaDiarrhea
Abdominal painAbdominal painAbdominal painAbdominal pain
BloatingBloatingBloatingBloating
ConstipationConstipationConstipationConstipation
NauseaNauseaMucous DischargeNausea
VomitingVomitingDyspepsiaVomiting
Early satiety
Extra-colonic manifestationsHeadacheAnemiaMajor depressionHives
MigraineOsteoporosisAnxietyAngioedema
Foggy mindNeurological disturbancesSomatoform disorderAsthma
FatiguePubertal delayFibromyalgiaCough
Eczema like rashDermatitis herpetiformisTemporomandibular disorderPost Nasal Drip
MyositisFoggy mindDyspareuniaEczema
NumbnessLymphoma
Psychological changes
Symptom OnsetHours to DaysHours to monthsUnclear relation to gluten ingestionMinutes to Hours
CytomorphologySmall bowel intraepithelial lymphocytosis (Marsh 0-1)Villous atrophy with crypt hyperplasiaNormalNormal
BiomarkersIgG-AGAIL-17(A)TNF- αIgE antibodies to wheat protein
ZonulinTCR-γδ IELsIL-6
LBPIgA tTGAIL-8
sCD14IgA EMA
CD3 + IELS
Zonulin
ImmunophenotypeHLA- DQ2 and DQ8 genotypes in 50% patientsHLA- DQ2 and DQ8 genotypes in 80% patientsIncrease in:Transforming growth factor-b (TGFb) mutations have been associated with higher rates of allergic disease
B cells expressing IgG or co-stimulatory molecules CD80 or CD86
T cells expressing b7 + HLADR+ and CD69+
DiagnosisSee figure 21Serologic testing followed by small bowel biopsyRome III diagnostic criteriaSkin prick test
Presence of serum IGE antibodies to wheat protein
ManagementGFDGFDSymptomatic treatment and elimination of stressorsGFD
ProbioticsSubcutaneous epinephrine for any acute episodes
AN-PEP
ICD codesK90.41K90.0K58K52.29

Citation: Igbinedion SO, Ansari J, Vasikaran A, Gavins FN, Jordan P, Boktor M, Alexander JS. Non-celiac gluten sensitivity: All wheat attack is not celiac. World J Gastroenterol 2017; 23(40): 7201-7210