Seronegative celiac disease: A case report


The paper describes a rare case of celiac disease in the absence of serum anti-tissue transglutaminase (anti-tTG) antibodies. A 51-year-old patient has been suffering from diarrheas for 20 years. He has lost 15 kg gradually; weakness progressed; muscle cramps, leg edemas, and signs of dynamic pseudoobstruction appeared. Morphological examination revealed small intestinal mucosal (SIM) villous atrophy (Marsh IIIC stage). IgA anti-tTG and IgG anti-tTG antibodies were 0.086 and 0.178, respectively. The patient was prescribed a gluten-free diet, water electrolyte solutions to correct metabolic disturbances, and prednisolone. During a control examination after 6 months, the patient had no complaints and gained 22 kg, and the SIM villus height was increased. The specific feature of the case is specific negative serological tests for celiac disease.


  1. De Gaetani M, Tennyson CA, Lebwohl B et al. Villous Atrophy and Negative Celiac Serology: A Diagnostic and Therapeutic Dilemma. Am J Gastroenterol. 2013;108:647-665.
  2. Sanders DS, Hurlstone DP, Mc Alindon ME, Hadjuvassiliou M, Cross SS, Wild G, Atkins CJ. Antibody negative celiac disease, presenting in elderly people-an easily missed diagnosis. BMJ. 2005;330:775-764.
  3. Rostami K, Kerckhaert J, Tiemessen R, von Blomberg ME, Meijer JWR, Mulder CJJ. Sensitivity of antiendomysium and antigliadin antibodies in untreated celiac disease: disappointing in clinical practice. Am J Gastroenterol. 1999;94:888-894.
  4. Enzo Ierardi, Giuseppe Losurdo, Domenico Piscitelli, Floriana Giorgio, Claudia Sorrentino, Mariabeatrice Principi, Lucia Montenegro, Annacinzia Amoruso, Alfredo Di Leo. Seronegative celiac disease where is the specific setting? Gastroenterol Hepatol Bench Bed. 2015;8:110-116.
  5. Eran C, Gwillim DS, Bowyer BA. Small bowel intestinal psevdo-obstruction and total atrophy of terminal ileum an unusual presentation of untreated celiac disease. Acc Case Rep J. 2013;1:22-24.
  6. Парфенов А.И., Крумс Л.М., Сиваш Э.С., Чикунова Б.З. Коллагеновая спру, как причина динамической кишечной непроходимости. Терапевтический архив. 2001;2:82-83.

Copyright (c) 2016 Krums L.M., Parfenov A.I., Sabelnikova E.A., Poleva N.I., Bykova S.V., Dubtsova E.A., Gudkova R.B., Khomeriki S.G., Rotin D.L., Pavlov M.V., Starostina N.S.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Managing Editor:

  • Tel.: +7 (926) 905-41-26
  • E-mail:


© 2018-2021 "Consilium Medicum" Publishing house

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies