Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CELIAC DISEASE”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,027 records · Page 57Linked to original sources
PubMedDate not supplied

Pediatric celiac disease: clinicopathologic and genetic aspects.

Evaluation for celiac disease (CD), an autoimmune enteropathy triggered by grain proteins in wheat, barley, rye, and possibly oats, is a common indication for pediatric endoscopy and biopsy. Duodenal or jejunal biopsy remains key for the initial diagnosis of CD. Small intestinal pathology may be diffuse or focal in CD, and histologic findings are nonspecific and must be interpreted in conjunction with clinical and serologic findings. A standardized grading system for CD biopsies is recommended. This review article summarizes the epidemiology, clinical manifestations, genetics, pathogenesis, and serologic and histologic findings of CD. Clinical management of CD and general handling of small intestinal biopsies are also addressed.

Biopsy↗
PubMed2004

[Importance of oral signs in the diagnosis of atypical forms of celiac disease].

The dramatic improvement in knowledge concerning celiac disease (CD) has disclosed the pattern of the associated clinical manifestations and the often atypical or silent presentation of this disease, which makes clinical diagnosis difficult. Also oral manifestations, mostly recurrent apthous stomatitis (RAS) and dental enamel hypoplasia, are atypical signs of CD. Our opinion about the possibility of performing mass-screening to reveal atypical or silent CD is in agreement whit who is asserting that a sistematical case-finding is, at present, the most suitable epidemiological approach. So, we think that patients affected by RAS, or dental enamel hypoplasia, should be considered, even in the absence of any gastrointestinal symptom, at-risk subjects, and should therefore undergo diagnostic procedure for CD.

Celiac Disease↗
PubMed1978

Visceral Kaposi's sarcoma. Occurrence in a patient suffering from celiac disease.

A case of visceral Kaposi's sarcoma occurred in a patient with adult celiac disease. A search of the literature has failed to disclose any previous case showing this association, although Kaposi's disease has been reported to occur in a variety of situations in which immunological abnormalities have been manifest. Conversely, celiac disease has been shown to predispose to the development of a variety of malignant neoplasms.

Biopsy↗
PubMedDate not supplied

[Dermatoglyphic patterns in celiac disease].

In 1990 a project was performed in Israel in which the authors reported a higher frequency of whorls and a lower frequency of ulnar loops in the dermatoglyphic pattern of children with celiac disease than in children belonging to control group. Based on these findings we carried out a similar study with our local population. Thirty six celiac children, their parents and siblings had their fingerprints analysed and compared to a control group matching for age, sex and race, in order to assess the efficiency of this method for the diagnosis of celiac disease. A statistically significant higher frequency of whorls and arches was found in celiac children than in control group (whorls = 40.6%, arches = 11.7%; whorls = 30.3%, arches = 5.0%, respectively) as well as a strong correlation between the dermatoglyphic pattern of the parents and their celiac children. There was also a statistically higher frequency of whorls > = 4 in celiac children (55.6%) than in controls (30.6%). The conclusion is that the dermatoglyphic pattern analysis can be used as a complementary data. Due to its low sensitivity (55.6%) and specificity (69.4%) considering the presence of four or more whorls, it is not useful as a screening or as a method itself, for the diagnosis of celiac disease.

Celiac Disease↗
PubMed1991

[Hyposplenism in celiac disease. Role of a gluten-free diet].

Hyposplenism is a common complication of adult celiac disease. A study of splenic function in 17 adult patients with celiac disease was performed both before and during treatment with a gluten-free diet. Splenic hypofunction was assessed evaluating morphological changes in red cells (Howell-Jolly bodies, spherocytosis, achantocytosis). The hyposplenic changes were compared with: age of patients, duration of symptoms previous to diagnosis, severity of the clinical picture and histological response to treatment. We concluded that 82.4% of patients had hyposplenic changes and that there was a non significant tendency to improve such changes by a strict adherence to gluten-free diet.

Adolescent↗
PubMed1983

Gm markers in celiac disease.

The association of Ig allotypes with celiac disease was analyzed in a sample of 95 Italian patients typed for HLA polymorphisms. No significant association was found for any Gm, A2m, or Km specificity when the overall sample was considered. However, significant different sex ratios were shown by patients' fnb positive and fnb negative genotypes, with a relative risk of 10.7 for this haplotype in males, suggesting that sex and Gm influence the penetrance of the HLA-linked genes. The significance of this finding is strengthened by the recent report that H-2 and Ig allotypes intervene in the genetic control of murine immune response to A-gliadin (M.F. Kagnoff, Nature 296:158, 1982).

Adult↗
PubMed2002

Incidence of enteropathy-associated T-cell lymphoma in celiac disease: implications for children and adolescents with type 1 diabetes.

The long-term consequences of screening for celiac disease in diabetic children are not known. Routine screening is not practiced in our pediatric diabetic population. This study of the incidence of the most severe and specific long-term complication of untreated celiac disease, i.e., enteropathy-associated T-cell lymphoma (EATCL) and its association with diabetes, is done in order to justify our strategy not to practice routine screening. In the first phase of this study, a questionnaire was sent to all Swiss pathologists. The second phase consisted of a search in the cancer registry of the canton of Zurich. The incidence of EATCL in the general population of a Swiss region and the theoretical risk for a diabetic patient to develop this type of lymphoma were calculated. Ten cases of EATCL were found. Five had a long history of malabsorption, three of them since childhood. The mean age of the patients was 61.9 yr. None suffered from diabetes mellitus. The incidence of EATCL was 0.07/100,000 inhabitants/year. The expected risk for EATCL in patients with type 1 diabetes is 12.4/100,000 diabetic patients over a period of 60 yr. The data suggest that the risk for EATCL is small in diabetic patients. Therefore, we restrict the investigation for celiac disease to patients with typical and atypical symptoms, but do not perform routine screening.

Journal Article↗
PubMed2000

[Immunomodulin efficacy in treatment of celiac disease in children].

Overall forty patients with celiac disease who ranged from 1 to 10 years old were kept under medical observation. Measured in the above patient population were the following parameters for cellular immunity: the content of T-, B- lymphocytes and of subpopulation of T-lymphocytes. In all patients, the content of T- and B-lymphocytes was reduced. 18 children received immunomodulin as a corrective measure in injections and a supporting dose in tablets over two months. There was an improvement in clinical symptomatology of the condition that was particularly apparent in the long-term results in the presence of increased values for T-lymphocytes in the group of patients having received immunomodulin against the background of basic therapy.

Adjuvants, Immunologic↗
PubMedDate not supplied

[How and why is the diagnostic approach to celiac disease changing].

The first classic description of celiac disease (CD) was published in 1888. The introduction in the clinical practice of the jejunal biopsy, in 1957, offered a powerful tool for a more objective approach to the disease. The correct diagnostic procedure for CD was finally established by a document of the European Society for Pediatric Gastro-enterology and Nutrition (ESPGAN) in 1970, and the ESPGAN suggestions were rapidly adopted by the scientific community. During these years, alternative and non-invasive diagnostic approaches were developed such as non-immunological (tests of intestinal absorption and permeability) and immunological (anti-reticulin, anti-endomysium and anti-gliadin antibodies, HLA antigens) tests. Due to the increased reliability of some of these laboratory investigations and to the increased knowledge about CD, it has been recently proposed that a simplification of the usual ESPGAN protocol should be eventually adopted in well defined subjects suspected to have CD.

Adult↗
PubMed1991

IgA anti-gliadin antibodies in adult celiac disease.

We have improved the enzyme-linked immunosorbent assay for IgA-class antibodies to gliadin in serum by evaluating earlier publications. We also assess the value of measuring these antibodies when screening for adult celiac disease and monitoring dietary compliance. Of 61 adults with untreated celiac disease, 57 had abnormal results, giving a sensitivity for the test of 0.93. Patients (n = 283) attending a gastroenterology clinic formed the control group. The predictive values of positive results and negative results were 50% and 99.7%, respectively, indicating that the test has a role in helping select those subjects in whom small bowel biopsy is indicated. Adults with celiac disease, after two years on a strict gluten-free diet, and normal subjects showed no significant difference in serum IgA-class anti-gliadin antibody concentrations. The test thus provides objective evidence of dietary compliance in addition to its role as a screening test.

Autoantibodies↗
PubMed2006

Hereditary fructose intolerance and celiac disease: a novel genetic association.

BACKGROUND & AIMS: Celiac disease (CD) has been associated with several genetic disorders, but has not been associated with hereditary fructose intolerance (HFI). METHODS: We identified CD in 4 female patients affected by HFI from among 38 Italian HFI patients. RESULTS: Three of these patients were children in whom the CD-associated signs were hypertransaminasemia, failure to thrive, low weight, and short stature, whereas the adult patient had protracted diarrhea notwithstanding a fructose-free diet. The incidence of CD in our group of HFI patients was higher (>10%) than in the general population (1%-3%) (P<.02). CONCLUSIONS: The possibility of an association between these 2 gastrointestinal disorders is important, particularly in the management of HFI patients with persisting symptoms.

Adult↗
PubMed1996

Increased prevalence of diabetes-related autoantibodies in celiac disease.

Forty-four nondiabetic patients with celiac disease (CD) were examined for the presence of insulin-dependent diabetes mellitus (IDDM)-related autoantibodies. Islet cell antibodies (ICA) were detected in 2 of 44 (4.5%). None of the 200 age- and sex-matched healthy controls was ICA positive (p < 0.05). Competitive anti-insulin antibodies (CIAA) were detected in 1 of 44 (2.5%) patients. First-phase insulin reserve (FPIR), stimulated insulin reserve (SIR), and glycosylated hemoglobin (GHB) levels were normal in the autoantibody-positive patients. Our data suggest that, like first-degree relatives of IDDM patients, CD patients are characterized by an increased prevalence of diabetes-related autoantibodies. Further follow-up is needed to determine whether the presence of these autoantibodies in nondiabetic CD patients predicts future IDDM.

Adolescent↗
PubMed2003

DXA vs QCT for subclinical celiac disease patients.

It has been recognized that celiac disease (CD) may be associated with osteoporosis. However, few data exist regarding bone disorders in adult patients with subclinical CD (SCD) and the best densitometric technique for assessing bone mineral density (BMD). We compared dual X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) in measuring the lumbar spine of 23 female patients with SCD and 19 healthy subjects. There were lower densitometric values in the subjects with SCD than the control group. We found discordance between DXA and QCT results using World Health Organization (WHO) criteria with the T score. With QCT as the reference method for its sensitivity, we found one false-negative, two false-positive and two misdiagnosed cases. We suggest some correction factors to improve DXA evaluation and screening of bone loss in CD.

Absorptiometry, Photon↗
PubMed2006

Eating disorders and celiac disease: a case report.

OBJECTIVE: Although chronic physical illness may be associated coincidentally with an eating disorder, some clinicians may overlook the possibility that another medical illness may coexist and contribute concurrently to symptoms such as peculiar eating behaviors, restrictive eating, and/or vomiting accompanied by body dissatisfaction. We present a 31-year-old single woman initially diagnosed with an atypical eating disorder. METHOD: After a gastroenterology consultation prompted by the atypical characteristics of her eating disturbance, the diagnosis of celiac disease was established. RESULTS: Cause-and-effect relationships between anorexia nervosa and celiac disease are unclear, and celiac disease may lead to confusion in the differential diagnosis of anorexia nervosa. CONCLUSION: Particularly in atypical cases, and in cases where nausea and bloating are prominent complaints, workup for celiac sprue may reveal the presence of this condition. In such instances, patients may achieve additional relief through the implementation of gluten-free diets.

Adult↗
PubMed1989

Early prediction of relapse during gluten challenge in childhood celiac disease.

Thirty-seven children, in whom celiac disease had been diagnosed because of flat mucosa on a gluten-containing diet and recovery on a gluten-free diet, were challenged with gluten powder, 10 g/day, in addition to an otherwise gluten-free diet. A small intestinal biopsy was performed before the challenge; clinical symptoms, a 1-h blood xylose test, and gliadin antibody measurement were used to establish the timing of the confirmatory biopsy. All but one case relapsed within 205 days (mode, 60 days). In no case was the relapse clinically evident. Raised levels of gliadin antibodies, a fall in xylose absorption, or both predicted the relapse in 37%, 7%, and 57% of cases, respectively. Evaluated individually, each test gave a considerable rate of false negative results. Discriminant coefficients produced for each test were used to compute a score that allowed the classification of patients into relapse/no relapse categories with a good degree of accuracy. The discriminant score rose sharply after only 15 days of challenge, indicating that it is possible to predict the relapse long before any clinical symptom appears.

Antibodies↗
PubMed2006

Celiac disease prevalence in Brazilian dilated cardiomyopathy patients.

Celiac disease (CD) is a permanent condition of gluten intolerance and a number of autoimmune diseases have been associated with it. In the past few years, a relation between CD and dilated cardiomyopathy (CM) was described in Europe and United States. The aim of this study was to evaluate the prevalence of CD among south Brazilian precardiac transplant patients with advanced CM. A total of 74 patients on a list for heart transplantation were evaluated for the presence CD. The presence of anti-endomisial antibody (IgA-EmA) was determined by indirect immunofluorescence and for the anti-transglutaminase antibody (IgA anti-h-tTG) by ELISA. Serologically positive patients were submitted to upper endoscopy with intestinal biopsy. Two individuals (2.63%) were positive for IgA-EmA and 5 (6.75%) for IgA anti-h-tTG; 1 (1.35%) had both tests positive. Histologic confirmation of CD occurred only in the IgA-EmA positive patients. In conclusion, data from the present study allows recommend the screening for CD in patients with CM using IgA-EmA test as the method of choice.

Adult↗
PubMed2005

Association of celiac disease and intestinal lymphomas and other cancers.

Celiac disease (CD) is associated with intestinal lymphoma and other forms of cancer, especially adenocarcinoma of the small intestine, of the pharynx, and of the esophagus. Enteropathy-associated T-cell lymphoma (EATL) is a rare form of high-grade, T-cell non-Hodgkin lymphoma (NHL) of the upper small intestine that is specifically associated with CD. This NHL subtype arises in patients with either previously or concomitantly diagnosed CD. In a subgroup of patients, there is progressive deterioration of a refractory form of CD. EATL derives from a clonal proliferation of intraepithelial lymphocytes and is often disseminated at diagnosis. Extraintestinal presentations are not uncommon in the liver/spleen, thyroid, skin, nasal sinus, and brain. The outlook of EATL is poor. Recent studies indicated that (1) CD is associated with a significantly increased risk for NHL, especially of the T-cell type and primarily localized in the gut (EATL); (2) the CD-lymphoma association is less common than previously thought, with a relative risk close to 3; (3) CD screening is not required in patients with NHL of any primary site at the onset, unless suggested by specific findings (T-cell origin and/or primary gut localization). The risk of NHL associated with clinically milder (or silent) forms could be lower than in typical cases of CD. Several follow-up studies suggest that the GFD protects from cancer development, especially if started during the first years of life. Strict adherence to the GFD seems to be the only possibility of preventing a subset of rare but very aggressive forms of cancer.

Adenocarcinoma↗
PubMed2004

Adaptive changes of duodenal iron transport proteins in celiac disease.

Iron deficiency is a manifestation of celiac disease (CD) usually attributed to a decreased absorptive surface, although no data on the regulation of iron transport under these conditions are currently available. Our aim was to evaluate divalent metal transporter 1 (DMT1), duodenal cytochrome b (Dcytb), ferroportin 1 (FP1), hephaestin, and transferrin receptor 1 (TfR1) expression, as well as iron regulatory protein (IRP) activity in duodenal biopsies from control, anemic, and CD patients. We studied 10 subjects with dyspepsia, 6 with iron-deficiency anemia, and 25 with CD. mRNA levels were determined by real-time PCR, protein expression by Western blotting or immunohistochemistry, and IRP activity by gel shift assay. Our results showed that DMT1, FP1, hephaestin, and TfR1 mRNA levels were significantly increased in CD patients with reduced body iron stores compared with controls, similar to what was observed in anemic patients. Protein expression paralleled the mRNAs changes. DMT1 protein expression was localized in differentiated enterocytes at the villi tips in controls, whereas with iron deficiency it was observed throughout the villi. FP1 expression was localized on the basolateral membrane of enterocytes and increased with low iron stores. TfR1 was localized in the crypts in controls but also in the villi with iron deficiency. These changes were paralleled by IRP activity, which increased in all iron-deficient subjects. We conclude that duodenal DMT1, FP1, hephaestin, and TfR1 expression and IRP activity, thus the iron absorption capacity, are upregulated in CD patients as a consequence of iron deficiency, whereas the increased enterocyte proliferation observed in CD has no effect on iron uptake regulation.

Adaptation, Physiological↗