This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The most reliable marker for CD is the finding of disordered small intestinal mucosa induced by the gliadin fraction of gluten and improvement by removal of dietary gliadin. Endomysial Antibody (EMA) and human Tissue Transglutaminase antibody (hTTG) are highly sensitive and specific for CD in the general population. Liver disease (LD) elicits a number of non-specific antibodies, and LD, especially cirrhosis, may alter mucosal architecture. In LD, neither validation of the utility of serologic tests for CD nor the range of findings of small bowel mucosal architecture has been reported. Verification that small bowel architecture is unaltered by cirrhosis, is required if biopsy findings are to be used to establish a diagnosis of CD in these patients.
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