title: 'For a quart of ale is a dish for a king': not always.
abstract: We report the case of a man with a clear diagnosis of coeliac disease who nevertheless drank gluten-containing beer. We found that a 4-week period of drinking gluten-containing beer did not provoke significant changes in the intestinal mucosa of this patient with coeliac disease nor did it elicit any relevant symptoms. Serum antibody levels rose but did not reach a pathological threshold. However, a more prolonged gluten challenge may have led to clinically relevant changes in IgA antitransglutaminase titres. This case demonstrates how important individual sensitivity to gluten in a patient with coeliac disease is in determining symptoms, immunological response and intestinal mucosa damage.
authors.affiliation: Department of Medicine and Surgery, AOU San Giovanni di Dio e Ruggi di Aragona, Salerno, Italy.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Zingone
authors.affiliation: Department of Medicine and Surgery, AOU San Giovanni di Dio e Ruggi di Aragona, Salerno, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Russo
authors.affiliation: Department of Clinical Pathology and Transfusion Medicine, AOU San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Massari
authors.affiliation: Department of Medicine and Surgery, AOU San Giovanni di Dio e Ruggi di Aragona, Salerno, Italy.
authors.forename: Carolina
authors.initials: C
authors.lastname: Ciacci
mesh_terms: D000328:Adult; D002446:Celiac Disease / Q000175:diagnosis / Q000178:diet therapy / Q000276:immunology*; D055050:Diet, Gluten-Free; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male
chemical_list: D007070:Immunoglobulin A