Impact of mass screening for gluten-sensitive enteropathy in working population

Table 1 Frequencies of clinical manifestations related to the degree of histological severity

	Normal mucosa (Marsh 0) n = 6 (%)	LE (Marsh I) n = 9 (%)	Atrophy (Marsh III) n = 6 (%)	Pvalue
Flatulence	4 (66.7)	6 (66.7)	4 (66.7)	1
Distension	2 (33.4)	7 (77.8)	4 (66.7)	0.282
Abdominal pain	0 (0.0)	6 (66.7)	4 (66.7)	0.029
Diarrhea	1 (16.7)	4 (44.5)	4 (66.7)	0.300
Asthenia	2 (33.4)	2 (22.3)	4 (66.7)	0.213
Anemia	0 (0)	0 (0)	1 (16.7)	0.571
Hypertransaminasemia	1 (16.7)	1 (11.9)	2 (33.3)	0.783

Statistical comparisons were made by an extension of Fisher’s exact test (Freeman-Halton test).

Table 2 Relationship between the values of VAS and degree of histological damage

	Normal mucosa (Marsh 0) n = 6	LE (Marsh I) n = 9	Atrophy (Marsh III) n = 6	Pvalue
Flatulence	36.6 ± 12.0 (0-60)	28.8 ± 8.2 (0-60)	36.6 ± 14.7 (0-80)	0.839
Distension	6.67 ± 4.2 (0-20)	28.8 ± 6.7 (0-60)	50.0 ± 16.9 (0-100)	0.035
Abdominal pain	0.0 ± 0.0 (0-20)	31.1 ± 10.0 (0-80)	26.6 ± 9.8 (0-60)	0.06
Diarrhea	8.33 ± 8.3 (0-50)	17.7 ± 9.1 (0-80)	30.0 ± 12.3 (0-80)	0.384
Asthenia	10.0 ± 6.8 (0-40)	11.1 ± 7.5 (0-60)	50.0 ± 16.9 (0-100)	0.031

Statistical comparisons were made by one-way ANOVA. Results are expressed as mean (SE) and range.

Table 3 Follow-up of patients who adhered to GFD

	At basal evaluation					After GFD
	Clinical features	EmA	tTGA (U/mL)	Biopsy	IELs	Clinical features	EmA	tTGA (U/mL)	Biopsy	IELs
Case 1 female 47 years	Flatulence, distension, abdominal pain, diarrhea, asthenia, anemia, osteopenia	> 1/160	74	Marsh IIIb	---	Asthenia	Neg.	3.3	Marsh I	35%
Case 2 female 24 years	Flatulence	> 1/160	159	Marsh IIIb	---	No symptoms	Neg.	1.9	---	---
Case 3 male 41 years	Flatulence, distension, abdominal pain, diarrhea, asthenia, hypertransaminasemia	> 1/160	63.4	Marsh IIIc	---	Asthenia, hypertransaminasemia	Neg.	2.0	Marsh I	28%
Case 4 female 32 years	Osteopenia	1/80	8.5	Marsh IIIa	---	Osteopenia	Neg.	0	---	---
Case 5 female 22 years	Distension, abdominal pain, diarrhea, asthenia, hypertransaminasemia, osteopenia	1/10	4.34	Marsh IIIb	---	Distension, osteopenia	Neg.	1.0	Marsh I	42%
Case 6 female 42 years	Flatulence, distension, osteopenia	Neg.	2.0	Marsh I	40%	Osteopenia	Neg.	2.4	Marsh 0	22%
Case 7 male 41 years	Osteopenia	Neg.	3.34	Marsh I	26%	No symptoms	Neg.	1.24	Marsh I	26%
Case 8 female 38 years	Flatulence, distension, abdominal pain	Neg.	4.04	Marsh I	42%	Flatulence	Neg.	2.0	Marsh 0	17%
Case 9 male 37 years	Distension, abdominal pain, diarrhea, osteopenia	Neg.	3.20	Marsh I	26%	Abdominal pain, diarrhea, osteopenia	Neg.	2.4	Marsh I	28%
Case 10 male 32 years	Flatulence, distension, abdominal pain, diarrhea, asthenia, osteopenia	Neg.	2.34	Marsh I	35%	Flatulence, distension, abdominal pain, diarrhea, asthenia, osteopenia	Neg.	1	Marsh 0	14%

Table 4 Evolution of symptoms after 1 year of follow-up for those patients who adhered to a GFD (n = 10; 5 Marsh I, 5 Marsh III)

	Basal (mean values of VAS)	After 1 year of GFD (mean values of VAS)	Pvalue
Flatulence	28 ± 8.9	5 ± 3.4	0.028
Distension	42 ± 10.9	7 ± 4.7	0.014
Abdominal pain	28 ± 9.0	7 ± 5.1	0.007
Diarrhea	24 ± 10.2	4 ± 2.6	0.063
Asthenia	28 ± 12.3	12 ± 6.6	0.133

Table 5 Patients who accepted follow-up but did not adhere to GFD

	At basal evaluation					Follow-up
	Clinical features	EmA	tTGA (U/mL)	Biopsy	IELs	Clinical features	EmA	tTGA (U/mL)	Biopsy	IELs
Case 1 male 23 years	Flatulence, distension, abdominal pain, diarrhea, asthenia	1/40	6.76	Marsh IIIb	----	Flatulence, distension, abdominal pain, diarrhea, asthenia	Neg.	1.70	Not accepted	---
Case 2 male 63 years	Osteopenia	Neg.	4.07	Marsh I	29%	Osteopenia	Neg.	2.2	Marsh I	25%
Case 3 male 24 years	Flatulence, distension, abdominal pain, diarrhea, asthenia	Neg.	3.47	Marsh I	25%	Flatulence, distension, diarrhea, asthenia	Neg.	1.0	Not accepted	---
Case 4 female 66 years	Flatulence, distension, abdominal pain	Neg.	5.60	Marsh I	35%	Diarrhea, abdominal pain, distension, flatulence	Neg.	15	Marsh IIIa	---
Case 5 male 45 years	Asthenia	Neg.	2.68	Marsh 0	5%	Asthenia	Neg.	2.0	Marsh I	28%
Case 6 male 47 years	Flatulence	Neg.	3.95	Marsh 0	22%	Flatulence	Neg.	1.0	Marsh 0	5%
Case 7 male 36 years	Distension	Neg.	2.78	Marsh 0	20%	Distension, hypertransaminasemia	Neg.	1.2	Not accepted	---
Case 8 male 36 years	Flatulence	Neg.	2.80	Marsh 0	18%	Flatulence	Neg.	1.0	Not accepted	---