Serological Investigation of Persistent Villous Atrophy in Celiac Disease.

Autoantibody levels were high only for tTG antibodies, which performed well in initial CeD diagnosis, but suboptimally for VA prediction during follow-up, as 14.6% of the follow-up patients with VA had low tTG-IgA. Increasing dilution improved tTG-IgA quantification, particularly when the antibody levels were extremely high, but did not significantly improve VA detection. Among those with low tTG-IgA and persistent VA, high proinflammatory cytokines were observed in two patients. Median LDL-C levels were significantly lower in the VA CeD group (P = 0.03). Apolipoprotein levels were similar in patients with and without VA, but diverged between those on a gluten-free diet (GFD) or not.Conclusions: tTG-IgA as a biomarker is suboptimal for villous atrophy prediction while on a GFD. Persistent villous atrophy is associated with low LDL-C levels, and partially related to persistent high proinflammatory cytokines.