Reviewer ’s report  
 
Title: Case report on pathogenetic link between gluten and IgA nephropathy  
 
Version: 0 Date: 04 Dec 2017  
 
Reviewer: Justine Turner  
 
Reviewer's report:  
 
This case report is worthy of publication because of rigorous methodology, . It would have 
benefited from longer follow up with repeat biopsy on a gluten free diet.  
 
Minor Suggestions  
Please review for language, the following are some suggestions to improve readability.  
Abstract: Line 13, delete 'in literature'. Lines 18 replace 'As the patient presented dyspepsia he 
was offered...' with 'In view of patient reported dyspepsia an upper gastrointestinal endoscopy 
with duodenal biopsies was undertaken and was normal.' Line 20, delete 'In absence of celiac 
serology and duodenal villus  atrophy'. New sentence begins with tTG -2... Line 22, add 'a 
continued' before gluten... Line 23, replace 'damage' with 'pathology'.  
Introduction: Line 3, replace 'demonstrated' with 'known'; replace 'reported' with 'report'. Line 6, 
replace 'patient' with  'patients'. Line 7, delete 'thus'. Line 9, delete "aimed to demonstrate this link 
using' replace with 'We used...' Lien 10, delete 'cystic fibrosis in whom' and 'occurred during a 
pulmonary exacerbation.'  
Case presentation: Page 3, line 23, replace "Apart  from' with 'While... (DQ2) were identified, 
both serum anti -endomysium...'; i.e. also delete 'no other finding consistent with celiac disease 
was identified.' Page 4, line 18, move the next sentence directly after this sentence - do not make 
a new paragra ph.  Line 19, delete 'only' and delete 'the patient had a remission of'. Change 
sentence to read 'After one month, proteinuria decreased to... and gross hematuria resolved.' Line 
23, change 'a new' to 'a repeat upper endoscopy...'. Line 26, move this singl e sentence up to the 
prior paragraph.  
Discussion: Line 4, need space between an infectious. Line 14, do not have single sentence as 
paragraph move next sentence on line 15 up here.  
Delete Table 1.  
Figures must be printed in color.  
Please indicate how many  intestinal biopsies were taken on both occasions, to be clear that celiac 
disease was not missed by insufficient biopsy number.  
 
Major Concern: could this not all be CF, as intestinal pathology mimicking CD can be seen in 
CF. This is a major problem you need to resolve and discuss. The best way to resolve would be 
to support your diagnosis of CD (in the absence of supporting serolog y) with a normal repeat 
intestinal biopsy on a gluten free diet.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of writt en English  
Please indicate the quality of language in the manuscript:  
 
Not suitable for publication unless extensively edited  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in a n organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial com peting interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree t o the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses.  I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do  not wish to be included in my named report can be included as confidential comments 
to the  editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Case report on pathogenetic link between gluten and IgA nephropathy  
 
Version: 0 Date: 04 Dec 2017  
 
Reviewer: Justine Turner  
 
Reviewer's report:  
 
This case report is worthy of publication because of rigorous methodology, . It would have 
benefited from longer follow up with repeat biopsy on a gluten free diet.  
 
Minor Suggestions  
Please review for language, the following are some suggestions to improve readability.  
Abstract: Line 13, delete 'in literature'. Lines 18 replace 'As the patient presented dyspepsia he 
was offered...' with 'In view of patient reported dyspepsia an upper gastrointestinal endoscopy 
with duodenal biopsies was undertaken and was normal.' Line 20, delete 'In absence of celiac 
serology and duodenal villus  atrophy'. New sentence begins with tTG -2... Line 22, add 'a 
continued' before gluten... Line 23, replace 'damage' with 'pathology'.  
Introduction: Line 3, replace 'demonstrated' with 'known'; replace 'reported' with 'report'. Line 6, 
replace 'patient' with  'patients'. Line 7, delete 'thus'. Line 9, delete "aimed to demonstrate this link 
using' replace with 'We used...' Lien 10, delete 'cystic fibrosis in whom' and 'occurred during a 
pulmonary exacerbation.'  
Case presentation: Page 3, line 23, replace "Apart  from' with 'While... (DQ2) were identified, 
both serum anti -endomysium...'; i.e. also delete 'no other finding consistent with celiac disease 
was identified.' Page 4, line 18, move the next sentence directly after this sentence - do not make 
a new paragra ph.  Line 19, delete 'only' and delete 'the patient had a remission of'. Change 
sentence to read 'After one month, proteinuria decreased to... and gross hematuria resolved.' Line 
23, change 'a new' to 'a repeat upper endoscopy...'. Line 26, move this singl e sentence up to the 
prior paragraph.  
Discussion: Line 4, need space between an infectious. Line 14, do not have single sentence as 
paragraph move next sentence on line 15 up here.  
Delete Table 1.  
Figures must be printed in color.  
Please indicate how many  intestinal biopsies were taken on both occasions, to be clear that celiac 
disease was not missed by insufficient biopsy number.  
 
Major Concern: could this not all be CF, as intestinal pathology mimicking CD can be seen in 
CF. This is a major problem you need to resolve and discuss. The best way to resolve would be 
to support your diagnosis of CD (in the absence of supporting serolog y) with a normal repeat 
intestinal biopsy on a gluten free diet.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of writt en English  
Please indicate the quality of language in the manuscript:  
 
Not suitable for publication unless extensively edited  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in a n organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial com peting interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree t o the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses.  I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do  not wish to be included in my named report can be included as confidential comments 
to the  editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Case report on pathogenetic link between gluten and IgA nephropathy  
 
Version: 0 Date: 04 Dec 2017  
 
Reviewer: Justine Turner  
 
Reviewer's report:  
 
This case report is worthy of publication because of rigorous methodology, . It would have 
benefited from longer follow up with repeat biopsy on a gluten free diet.  
 
Minor Suggestions  
Please review for language, the following are some suggestions to improve readability.  
Abstract: Line 13, delete 'in literature'. Lines 18 replace 'As the patient presented dyspepsia he 
was offered...' with 'In view of patient reported dyspepsia an upper gastrointestinal endoscopy 
with duodenal biopsies was undertaken and was normal.' Line 20, delete 'In absence of celiac 
serology and duodenal villus  atrophy'. New sentence begins with tTG -2... Line 22, add 'a 
continued' before gluten... Line 23, replace 'damage' with 'pathology'.  
Introduction: Line 3, replace 'demonstrated' with 'known'; replace 'reported' with 'report'. Line 6, 
replace 'patient' with  'patients'. Line 7, delete 'thus'. Line 9, delete "aimed to demonstrate this link 
using' replace with 'We used...' Lien 10, delete 'cystic fibrosis in whom' and 'occurred during a 
pulmonary exacerbation.'  
Case presentation: Page 3, line 23, replace "Apart  from' with 'While... (DQ2) were identified, 
both serum anti -endomysium...'; i.e. also delete 'no other finding consistent with celiac disease 
was identified.' Page 4, line 18, move the next sentence directly after this sentence - do not make 
a new paragra ph.  Line 19, delete 'only' and delete 'the patient had a remission of'. Change 
sentence to read 'After one month, proteinuria decreased to... and gross hematuria resolved.' Line 
23, change 'a new' to 'a repeat upper endoscopy...'. Line 26, move this singl e sentence up to the 
prior paragraph.  
Discussion: Line 4, need space between an infectious. Line 14, do not have single sentence as 
paragraph move next sentence on line 15 up here.  
Delete Table 1.  
Figures must be printed in color.  
Please indicate how many  intestinal biopsies were taken on both occasions, to be clear that celiac 
disease was not missed by insufficient biopsy number.  
 
Major Concern: could this not all be CF, as intestinal pathology mimicking CD can be seen in 
CF. This is a major problem you need to resolve and discuss. The best way to resolve would be 
to support your diagnosis of CD (in the absence of supporting serolog y) with a normal repeat 
intestinal biopsy on a gluten free diet.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of writt en English  
Please indicate the quality of language in the manuscript:  
 
Not suitable for publication unless extensively edited  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in a n organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial com peting interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree t o the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses.  I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do  not wish to be included in my named report can be included as confidential comments 
to the  editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant