P096 Children with “borderline” TTG values in a screening for Coeliac disease on school population: follow-up after two years

We have previously shown that 67% of patients with newly diagnosed coeliac disease (CD) presenting to gastroenterologists have evidence of neurological dysfunction. This manifested with headache and loss of co-ordination. Furthermore 60% of these patients had abnormal brain imaging. In this follow-up study, we re-examined and re-scanned 30 patients from the original cohort of 100, seven years later. There was significant reduction in the prevalence of headaches (47% to 20%) but an increase in the prevalence of incoordination (27% to 47%). Although those patients with coordination problems at baseline reported improvement on the gluten free diet (GFD), there were 7 patients reporting incoordination not present at baseline. All 7 patients had positive serology for one or more gluten-sensitivity related antibodies at follow-up. In total, 50% of the whole follow-up cohort were positive for one or more gluten-related antibodies. A comparison between the baseline and follow-up brain imaging showed a greater rate of cerebellar grey matter atrophy in the antibody positive group compared to the antibody negative group. Patients with CD who do not adhere to a strict GFD and are serological positive are at risk of developing ataxia, and have a significantly higher rate of cerebellar atrophy when compared to patients with negative serology. This highlights the importance of regular review and close monitoring.

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Cancer incidence and factors associated with malignancies in coeliac disease during long‐term follow‐up

GastroHep ◽

10.1002/ygh2.446 ◽

2021 ◽

Vol 3 (2) ◽

pp. 107-115

Author(s):

Inka Koskinen ◽

Kaisa Hervonen ◽

Eero Pukkala ◽

Timo Reunala ◽

Katri Kaukinen ◽

...

Keyword(s):

Coeliac Disease ◽

Cancer Incidence ◽

Factors Associated ◽

Long Term Follow Up

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Epilepsy, cerebral calcifications and clinical or subclinical coeliac disease. Course and follow up with gluten-free diet

Seizure ◽

10.1016/s1059-1311(98)90008-5 ◽

1998 ◽

Vol 7 (1) ◽

pp. 49-54 ◽

Cited By ~ 23

Author(s):

Miguel A. Hernandez ◽

Gema Colina ◽

Luis Ortigosa

Keyword(s):

Coeliac Disease ◽

Gluten Free Diet ◽

Disease Course ◽

Gluten Free ◽

Cerebral Calcifications

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Classroom Performance and Social Factors of Children With Birth Weights of 1,250 Grams or Less: Follow-up at 5 to 8 Years of Age

PEDIATRICS ◽

10.1542/peds.77.2.203 ◽

1986 ◽

Vol 77 (2) ◽

pp. 203-208

Author(s):

Betty Lou Eilers ◽

Nirmala S. Desai ◽

Melissa A. Wilson ◽

M. Douglas Cunningham

Keyword(s):

Grade Level ◽

Teaching Staff ◽

Classroom Performance ◽

Educational Levels ◽

Older Mothers ◽

School Population ◽

General School ◽

Long Term Survivors

Of 43 long-term survivors with birth weights of 1,250 g or less, 33 were compared with peers and school-aged siblings for educational levels and needs. Of the 33 children in school, three (9.1%) were in classes for children with major handicaps, whereas 30 (90.9%) were found to be comparable to their classmates by teachers and/or test scores, but 14 (47%) were receiving remedial instruction to perform at grade level. Of 13 children with school-aged siblings, three required more hours of assistance by specialized teaching staff than their siblings. The group without the need for specialized teaching staff had older mothers and tended to reside in higher socioeconomic households. Overall, our children with birth weights of 1,250 g or less (51.5%) required more special education efforts than the general school population (24.1%), thereby enabling most to compare favorably with their peers.

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Coeliac crisis mimicking nephrotic syndrome in a post-partum patient

Scottish Medical Journal ◽

10.1177/0036933019853170 ◽

2019 ◽

Vol 64 (3) ◽

pp. 116-118

Author(s):

Özant Helvacı ◽

Seyma Yıldız ◽

Berfu Korucu ◽

Ulver Derici ◽

Turgay Arinsoy

Keyword(s):

Nephrotic Syndrome ◽

Coeliac Disease ◽

Post Partum ◽

Lower Extremity Weakness ◽

Case Presentation ◽

Multisystem Involvement ◽

Life Threatening ◽

History Of ◽

Rare Occasion

Background Coeliac crisis is a life-threatening presentation of coeliac disease. Severe diarrhoea, weight loss, electrolyte imbalances and malnutrition are prominent features. Although mainly a disease of childhood, it can on the rare occasion be diagnosed in adults. Case presentation A 25-year-old female with severe generalised oedema, lower extremity weakness, hypokalemia and profound hypoalbuminemia was referred with an initial diagnosis of nephrotic syndrome. Three months previously she had given birth to a healthy child following an uneventful pregnancy. She did not have proteinuria. She had a history of diarrhoea with gluten-containing food since childhood but lacked a formal diagnosis of coeliac disease. A duodenal biopsy confirmed the suspected diagnosis. Coeliac crisis was diagnosed with life-threatening multisystem involvement. Introduction of a gluten-free diet abolished all disease symptoms and ameliorated laboratory parameters at six months’ follow-up. Conclusion Coeliac crisis is a rare, yet dangerous presentation of coeliac disease in adults. As this case suggests, it can present with generalised oedema and hypoalbuminemia mimicking nephrotic syndrome. Rapid diagnosis is the key to successful treatment.

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Long-term follow-up of coeliac disease - what do coeliac patients want?

Alimentary Pharmacology & Therapeutics ◽

10.1111/j.1365-2036.2006.02824.x ◽

2006 ◽

Vol 23 (6) ◽

pp. 827-831 ◽

Cited By ~ 37

Author(s):

J. R. BEBB ◽

A. LAWSON ◽

T. KNIGHT ◽

R. G. LONG

Keyword(s):

Coeliac Disease ◽

Long Term Follow Up

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Interventions to Increase Adherence to a Gluten Free Diet in Patients with Coeliac Disease: A Scoping Review

Gastrointestinal Disorders ◽

10.3390/gidisord2030029 ◽

2020 ◽

Vol 2 (3) ◽

pp. 318-326

Author(s):

Humayun Muhammad ◽

Sue Reeves ◽

Sauid Ishaq ◽

Yvonne Jeanes

Keyword(s):

Coeliac Disease ◽

Intervention Studies ◽

Gluten Free Diet ◽

Online Course ◽

Dietary Adherence ◽

Inflammatory Disorder ◽

Gluten Free ◽

Robust Methods ◽

Chronic Inflammatory Disorder

Coeliac disease is a chronic inflammatory disorder of the small bowel, characterised by permanent intolerance to gluten. The only current and effective treatment for coeliac disease is a gluten free diet [GFD], however this is challenging for patients to adhere to. The review aims to identify published interventions designed to improve patients’ adherence to a GFD. Ten intervention studies were identified and included within the review; whilst heterogeneous in delivery, all included an educational, behavioural, and practical element. Five interventions significantly improved dietary adherence, these included follow-up appointments, a telephone clinic, an online course, cooking sessions and psychological support. All studies were small and used varied methods to assess adherence. There is a paucity of well-designed interventions to promote dietary adherence, in future more robust methods for ascertaining adherence is needed, we recommend greater inclusion of dietetic assessment and combining more than one method for assessing adherence.

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