A Clinical Update

Nonceliac Gluten Sensitivity—Is it Really the Gluten?

Bernadette Capili, PhD, NP-C; Michelle Chang, MS; Joyce K. Anastasi, PhD, DrNP


Journal for Nurse Practitioners. 2014;10(9):666-673. 

In This Article

Differences Between CD and NCGS

CD is an autoimmune disorder and disease of malabsorption that occurs in genetically susceptible individuals.[8] CD is associated with specific human leukocyte antigen (HLA) class II genes, known as HLA-DQ2 and HLA-DQ8.[8] HLA-DQ2 is found in up to 90% to 95% of patients with CD, whereas most of the remaining patients have HLA-DQ8.[16] With CD, the ensuing inflammatory response in the small intestine leads to mucosal villous atrophy, crypt hyperplasia, and lymphocyte infiltration.[15] Unlike CD, the small intestine biopsy in NCGS is usually characterized by normal mucosa or a mild increase in intraepithelial lymphocytes.[14] Based on current evidence, it appears that NCGS does not have a strong hereditary basis, is not associated with malabsorption, and does not have an increased risk for long-term complications, such as autoimmune disorders or intestinal malignancy.[5]