scholarly journals Non-classical clinical presentation at diagnosis by male celiac disease patients of older age

2021 ◽  
Vol 83 ◽  
pp. 28-33 ◽  
Author(s):  
Ineke L. Tan ◽  
Sebo Withoff ◽  
Jeroen J. Kolkman ◽  
Cisca Wijmenga ◽  
Rinse K. Weersma ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Clinical Presentation ◽  
Older Age

scholarly journals Efficient implementation of the ‘non-biopsy approach’ for the diagnosis of childhood celiac disease in the Netherlands: a national prospective evaluation 2010–2013

2021 ◽  
Author(s):  
Caroline R. Meijer ◽  
Joachim J. Schweizer ◽  
Anne Peeters ◽  
Hein Putter ◽  
M. Luisa Mearin
Keyword(s):  
Celiac Disease ◽  
The Netherlands ◽  
Clinical Presentation ◽  
Paediatric Population ◽  
Hla Typing ◽  
Newly Diagnosed ◽  
Prospective Evaluation ◽  
Espghan Guidelines ◽  
Intestinal Symptoms ◽  
Nationwide Implementation

AbstractThe aim of this study was (1) to prospectively evaluate the nationwide implementation of the ESPGHAN-guidelines for the diagnosis of celiac disease (CD), (2) to investigate the incidence and clinical presentation of diagnosed childhood CD (0–14 years) in the Netherlands, and (3) to compare the findings with national survey data from 1975 to 1990 and 1993 to 2000 using the same approach. From 2010 to 2013, all practicing paediatricians were invited to report new celiac diagnoses to the Dutch Pediatric Surveillance Unit. Data were collected via questionnaires. A total of 1107 children with newly diagnosed CD were reported (mean age, 5.8 years; range, 10 months–14.9 years; 60.5% female). After the introduction of the non-biopsy approach in 2012, 75% of the diagnoses were made according to the guideline with a significant decrease of 46.3% in biopsies. The use of EMA and HLA-typing significantly increased with 25.8% and 62.1%, respectively. The overall incidence rate of childhood CD was 8.8-fold higher than in 1975–1990 and 2.0-fold higher than in 1993–2000. During the study period, the prevalence of diagnosed CD was 0.14%, far below 0.7% of CD identified via screening in the general Dutch paediatric population. Clinical presentation has shifted towards less severe and extra-intestinal symptoms.Conclusion: ESPGHAN guidelines for CD diagnosis in children were effectively and rapidly implemented in the Netherlands. Incidence of diagnosed CD among children is still significantly rising with a continuous changing clinical presentation. Despite the increasing incidence of diagnoses, significant underdiagnosis still remains. What is Known:• Since 2000 the incidence of diagnosed childhood CD in the Netherlands has shown a steady rise.• The rise in incidence has been accompanied by a changing clinical presentation at diagnosis. What is New:• The ESPGHAN guidelines 2012 for CD diagnosis were effectively and rapidly implemented in the Netherlands.• The incidence of diagnosed childhood CD in the Netherlands has continued to rise significantly during the reported period.

Relationships between Clinical Presentation, Serology, Histology, and Duodenal Deposits of Tissue Transglutaminase Antibodies in Pediatric Celiac Disease

2018 ◽  
Vol 36 (5) ◽  
pp. 369-376 ◽  
Author(s):  
Nurit Loberman-Nachum ◽  
Michael Schvimer ◽  
Camila Avivi ◽  
Iris Barshack ◽  
Avishay Lahad ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Immunohistochemical Staining ◽  
Clinical Presentation ◽  
Tissue Transglutaminase ◽  
Mucosal Damage ◽  
High Serum ◽  
Tissue Transglutaminase Antibodies ◽  
Antibody Levels ◽  
Age Range ◽  
Multiple Symptoms

Background: The clinical, histological, and serological spectrum of celiac disease (CD) vary widely. We aimed to examine relationships between symptoms, serum anti-tissue transglutaminase antibodies (tTG) levels, mucosal damage, and mucosal anti-tTG deposits in pediatric CD. Methods: A retrospective single-center, cohort study of children referred for endoscopy with suspected CD during 2011–2014. We retrieved the clinical data, blindly reviewed duodenal biopsies, and performed immunohistochemical staining for anti-tTG deposits. Patients were classified as monosymptomatic or polysymptomatic. Mucosal anti-tTG deposits were classified according to the location of deposits, dominant intensity, maximal intensity, and percentage of stained area. Results: Of 252 patients with confirmed CD, complete data were available for 100: 37 males in the age range 1.3–16.7 with median 4.0 years. Monosymptomatic patients (n = 54) presented at an older age than polysymptomatic patients (1.3–15.5, median 8.1 vs. 1.3–16.7, median 6.3 years, p = 0.026). Marsh 2–3c was more prevalent in polysymptomatic patients (93 vs. 78%, p = 0.028). The intensity of mucosal anti-tTG deposits correlated with serum anti-tTG levels but not with the clinical presentation. Conclusions: Multiple symptoms and high serum anti-tTG antibody levels correlated with mucosal damage in children with CD. The role of immunohistochemical staining for intestinal anti-tTG mucosal deposits in the diagnosis of borderline CD is not yet established.

scholarly journals A146 TRENDS IN THE CLINICAL PRESENTATION OF CELIAC DISEASE AT DIAGNOSIS IN CHILDREN IN QUEBEC

2019 ◽  
Vol 2 (Supplement_2) ◽  
pp. 290-291
Author(s):  
O V Portolese ◽  
T Nguyen ◽  
D Dal Soglio ◽  
N Patey ◽  
L Oligny ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Clinical Presentation

scholarly journals Management of celiac disease: from evidence to clinical practice

2017 ◽  
Vol 11 (4) ◽  
pp. 345
Author(s):  
Tiziana M. Attardo ◽  
Elena Magnani ◽  
Carlotta Casati ◽  
Danilo Cavalieri ◽  
Pietro Crispino ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Diagnostic Tests ◽  
Genetic Factors ◽  
Clinical Presentation ◽  
Scientific Evidence ◽  
Methodological Approach ◽  
Human Leukocyte ◽  
Gluten Sensitivity ◽  
Adoptive Immunity

Celiac disease (CD) is a complex polygenic disorder, which involves genetic factors human leukocyte complex (HLA) and non-HLA genes, environmental factors, innate and adoptive immunity, and a robust chronic T-mediated autoimmune component. The main goal of the present monograph is to define a methodological approach for the disease, characterized by frequent late diagnosis, in order for the physician to become aware of the disease management, the diversity of the clinical presentation itself and in different patients. A unique attention is payed to the specific diagnostic tests to define a correct and accurate application of them, and in addition, to disease follow-up and possible complications. Moreover, a dedicated space is assigned to refractory CD, to potential CD and non-celiac gluten sensitivity. Legislative aspects of the celiac disease in Italy are addressed, too. The celiac disease guidelines and their evaluation by means of Appraisal of Guidelines, Research and Evaluation II instrument allow us to classify the different recommendations and to apply them according to the stakeholders’ involvement, pertinence, methodological accuracy, clarity and publishing independence. Finally, the most current scientific evidence is taken into account to create a complete updated monograph.

The Changing Clinical Presentation of Celiac Disease

2008 ◽  
pp. 18-22 ◽  
Author(s):  
E. Lebenthal ◽  
E. Shteyer ◽  
D. Branski
Keyword(s):  
Celiac Disease ◽  
Clinical Presentation

Degree of Damage to the Small Bowel and Serum Antibody Titers Correlate With Clinical Presentation of Patients With Celiac Disease

2013 ◽  
Vol 11 (2) ◽  
pp. 166-171.e1 ◽  
Author(s):  
Juha Taavela ◽  
Kalle Kurppa ◽  
Pekka Collin ◽  
Marja–Leena Lähdeaho ◽  
Teea Salmi ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Small Bowel ◽  
Clinical Presentation ◽  
Serum Antibody ◽  
Antibody Titers ◽  
Degree Of Damage

Macrohematuria Caused by a Fall in Prothrombin Activity as a Clinical Presentation of Celiac Disease

2002 ◽  
Vol 35 (4) ◽  
pp. 359-360 ◽  
Author(s):  
Ali M. Moussa ◽  
Giulia Martina Cavestro ◽  
Paolo Coruzzi ◽  
Marta Maino ◽  
Gian Luigi De Angelis ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Clinical Presentation ◽  
Prothrombin Activity

Gender and Clinical Presentation in Adult Celiac Disease

1995 ◽  
Vol 30 (11) ◽  
pp. 1077-1081 ◽  
Author(s):  
C. Ciacci ◽  
M. Cirillo ◽  
R. Sollazzo ◽  
G. Savino ◽  
F. Sabbatini ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Clinical Presentation ◽  
Adult Celiac Disease

scholarly journals Presentation and outcomes of chronic kidney disease patients with COVID-19

2021 ◽  
Author(s):  
Carolina Gonçalves Branco ◽  
Inês Duarte ◽  
Joana Gameiro ◽  
Cláudia Costa ◽  
Filipe Marques ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Multivariate Analysis ◽  
Kidney Disease ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Older Age ◽  
Global Health Issue ◽  
Independent Risk Factors

Abstract Introduction: COVID-19 is currently a global health issue and an important cause of mortality. Chronic kidney disease (CKD) is one of the risk factors for infection, morbidity and mortality by SARS-CoV-2. In our study, we aimed to evaluate the clinical presentation and outcomes of CKD patients with COVID-19, as well as identify predictors of mortality. Methods: This was a retrospective study of CKD patients admitted in a tertiary-care Portuguese hospital between March and August of 2020. Variables were submitted to univariate and multivariate analysis to determine factors predictive of in-hospital mortality. Results: 130 CKD patients were analyzed (median age 73.9 years, male 60.0%). Hypertension (81.5%), cardiovascular disease (36.2%), and diabetes (54.6%) were frequent conditions. Cough, dyspnea, fever and respiratory failure were also common. Almost 60% had anemia, 50% hypoalbuminemia, 13.8% hyperlactacidemia and 17% acidemia. Mean serum ferritin was 1531 µg/L, mean CRP 8.3 mg/dL and mean LDH 336.9 U/L. Most patients were treated with lopinavir/ritonavir, hydroxychloroquine or corticosteroids and only 2 with remdesivir. Eighty percent had acute kidney injury and 16.2% required intensive care unit admission. The 34 patients who died were older and more likely to have heart failure. They had higher neutrophils/lymphocytes ratio, ferritin, lactate, and LDH levels. Multivariate analysis identified an association between older age [OR 1.1 (CI 1.01-1.24), p=0.027], higher ferritin [OR 1.0 (CI 1.00-1.00), p=0.009] and higher LDH levels [OR 1.0 (CI 1.00-1.01), p=0.014] and mortality. Conclusion: In our cohort of CKD patients with COVID-19, older age, higher ferritin, and higher LDH levels were independent risk factors for mortality.

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