Investigation of Tissue Transglutaminase Antibody Normalization in Response to Gluten-Free Diet in Children with Celiac Disease

AbstractA very limited amount of data are available regarding the follow-up of celiac disease (CD) treatment in Iran. The aim of this study is to investigate antitissue transglutaminase (atTG) normalization interval and the associated factors in CD patients. This retrospective study included CD patients enrolled in Children's Medical Center, Tehran University of Medical Sciences. The initial atTG titer and histological evaluation (with Marsh grade ≥2) were recorded. The atTG titer was assessed in each follow-up until the time of normalization where children were strictly on gluten-free diet. The age at the time of diagnosis, gender, Marsh grade at the time of diagnosis, other comorbidities, and family history of CD patients were recorded to determine the association of these factors with antibody normalization interval. In total, 71 patients were recruited in the study of which 34 (47.89%) subjects had atTG level below 20 U/mL at the average interval of 31.36 ( ± 2.89) months (95% confidence interval: 25.7–37.02). There was no significant difference between the antibody normalization interval and different age ranges and Marsh grade. Cox regression demonstrated that gender, age ranges, Marsh grade, positive family history of CD, and the presence of comorbidities did not significantly predict longer antibody normalization interval.

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An Attempt of Specific Desensitising Treatment with Gliadin in Celiac Disease

International Journal of Immunopathology and Pharmacology ◽

10.1177/039463200501800413 ◽

2005 ◽

Vol 18 (4) ◽

pp. 709-714 ◽

Cited By ~ 4

Author(s):

G. Patriarca ◽

N. Pogna ◽

G. Cammarota ◽

D. Schiavino ◽

C. Lombardo ◽

...

Keyword(s):

Celiac Disease ◽

Tissue Transglutaminase ◽

Clinical Manifestations ◽

Current Treatment ◽

Gluten Free Diet ◽

Gluten Free ◽

Dietary Regimen ◽

New Approach ◽

Tissue Transglutaminase Antibodies

Gluten-free diet is the current treatment of celiac disease. We decided to verify the occurrence of histological and serological modification and/or clinical manifestations during a gradual and progressive introduction of gliadin in the diet and if it may induce a tolerance to food, as it occurs in allergic patients. We studied the case of a celiac woman with complete clinical and histological remittance after 10 years of gluten free diet. She took increasing daily doses of gliadin, reaching the final dose of 9 g of gliadin (15 g of gluten) in 6 months. Then she started a free dietary regimen. During the 15-month follow-up period esophago-gastro-duodenoscopy showed normal Kerckring folds and villi. Anti-gliadin, anti-endomysium and anti-tissue-transglutaminase antibodies, as well as the haematological and biochemical parameters remained normal. Our results represent a new approach in the research concerning celiac disease, and could provide a future line of study for its management.

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Abdominal Aortic Aneurysms No Not Develop More Aggressively Among Patients With a Positive Family History of the Disease

10.52916/jmrs204035 ◽

2020 ◽

pp. 1-7

Author(s):

Trine Maria Mejnert Joergensen

Keyword(s):

Family History ◽

Growth Rates ◽

Positive Family History ◽

Aortic Aneurysms ◽

Study Materials ◽

Abdominal Aortic ◽

Significant Difference ◽

History Of ◽

Time Of Operation

Introduction: It is well known that a family history of Abdominal Aortic Aneurysm (AAA) strongly increases the risk of developing AAA, but it is still unknown whether familial AAAs develop differently than non-familial AAAs. Objectives: To investigate whether familial AAAs develop more aggressively than non-familial AAAs by looking at the growth rate, risk of surgery and rupture, as well as the size of the aneurysm at the time of diagnosis and the patient’s age at the time of operation, rupture and diagnosis. Design: Observational retrospective longitudinal study. Materials and Methods: 318 patients with AAA diagnosed between 1996-2008 in Jutland, Denmark with information on family history of AAA, the diameter of AAA throughout follow-up, surgery, ruptures, comorbidity, smoking, and use of medication. Patients with and without a family history of AAA were compared regarding mean age at diagnosis and surgery, the diameter of AAA at diagnosis, risk of surgery and rupture as well as comorbidity and use of medication. Mean growth rates were compared between the two groups and a mixed-effects model was fitted to control for confounders. Results: We included 93 patients with and 225 without a family history of AAA. Patients with a family history of AAA ere significantly younger than patients with no family history of the disease (69.8 vs. 72.4 years, p=0.032), but we found no significant differences in age at operation (72.2 vs. 70.6, p=0.204), the proportion of patients experiencing rupture (16.0 vs. 10.6%, p=0.226) or undergoing surgery (78.2% vs. 81.7%, p=0.484). We found no significant difference in growth rates between the two groups; 5.25 mm/year for patients with positive family history and 6.19 mm/year for patients with no family history of AAA (p=0.490). Conclusions: We found no evidence to suggest that AAA develops more aggressively in patients with a positive family history of the disease.

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Evaluation of Breast Cancer Awareness Campaign, Screening Drivers

Journal of Global Oncology ◽

10.1200/jgo.18.56000 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 26s-26s

Author(s):

K. Ammar ◽

S. Alsater

Keyword(s):

Breast Cancer ◽

Family History ◽

Early Detection ◽

Strong Predictor ◽

Positive Family History ◽

Diagnostic Group ◽

Screening Rate ◽

Significant Difference ◽

History Of

Background: King Hussein Cancer Foundation and Center (KHCF & KHCC) lead Breast Cancer (BC) awareness in Jordan through the Jordan Breast Cancer Program. The program aims to reduce morbidity and mortality from BC, and shift the current state of diagnosis from late stages to earlier ones, where the disease is curable, survival rates are higher, and treatment costs are lower. In October, the international BC awareness month, many activities are organized to encourage Jordanian women to undergo screening. Aim: To find out predictors of screening visits at KHCC early detection clinic in October 2015 to evaluate echo of the campaign. In addition, we aim to find the screening rate among women at KHCC early detection clinic. Methods: This is a cross sectional study, using a self-administered questionnaire, carried out in October 2015 and follow-up was completed on August 2016. Results: 291 women responded to the questionnaire, they were categorized into two groups; screening and diagnostic. Screening rate was 57.8% (N=166). In women above 40 years old, 69.3% (N=113) were in the screening group and 30.7% (N= 50) in the diagnostic group. There was no statistically significant difference in the average ages between two groups (49.49 year, 47.82 year, P = 0.218). Positive family history of BC in a first-degree relative was found to be a strong predictor for mammogram screening in comparison with screening group (65.4% vs 16%, P = 0.05); other screening behaviors like commitment to self-breast exam, clinical breast exam and attending educational lecture about BC did not significantly affect screening rates. In addition, screened women were more likely to complete their investigations and follow-up procedures. In this sample, five women were diagnosed with BC; two in advanced stages among the diagnostic group 4%, (N=50) with mean age 54.5 year, and three in early stage among screened group 2.7%, (N=113) with a mean age of 50 year. Conclusion: First-degree family history of BC is a strong predictor of BC screening. Awareness activities might lead to higher screening rates among women in general. Further studies need to be conducted on larger scale to confirm the results of this study.

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Rationale for Timing of Follow-Up Visits to Assess Gluten-Free Diet in Celiac Disease Patients Based on Data Mining

Nutrients ◽

10.3390/nu13020357 ◽

2021 ◽

Vol 13 (2) ◽

pp. 357

Author(s):

Alfonso Rodríguez-Herrera ◽

Joaquín Reyes-Andrade ◽

Cristina Rubio-Escudero

Keyword(s):

Data Mining ◽

Celiac Disease ◽

Cultural Context ◽

Gluten Free Diet ◽

Gluten Free ◽

Adherence To Diet ◽

And Gender ◽

Few Data

The assessment of compliance of gluten-free diet (GFD) is a keystone in the supervision of celiac disease (CD) patients. Few data are available documenting evidence-based follow-up frequency for CD patients. In this work we aim at creating a criterion for timing of clinical follow-up for CD patients using data mining. We have applied data mining to a dataset with 188 CD patients on GFD (75% of them are children below 14 years old), evaluating the presence of gluten immunogenic peptides (GIP) in stools as an adherence to diet marker. The variables considered are gender, age, years following GFD and adherence to the GFD by fecal GIP. The results identify patients on GFD for more than two years (41.5% of the patients) as more prone to poor compliance and so needing more frequent follow-up than patients with less than 2 years on GFD. This is against the usual clinical practice of following less patients on long term GFD, as they are supposed to perform better. Our results support different timing follow-up frequency taking into consideration the number of years on GFD, age and gender. Patients on long term GFD should have a more frequent monitoring as they show a higher level of gluten exposure. A gender perspective should also be considered as non-compliance is partially linked to gender in our results: Males tend to get more gluten exposure, at least in the cultural context where our study was carried out. Children tend to perform better than teenagers or adults.

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Descriptive Study of the Different Tools Used to Evaluate the Adherence to a Gluten-Free Diet in Celiac Disease Patients

Nutrients ◽

10.3390/nu10111777 ◽

2018 ◽

Vol 10 (11) ◽

pp. 1777 ◽

Cited By ~ 5

Author(s):

Luis Rodrigo ◽

Isabel Pérez-Martinez ◽

Eugenia Lauret-Braña ◽

Adolfo Suárez-González

Keyword(s):

Celiac Disease ◽

Multidisciplinary Approach ◽

Descriptive Study ◽

Duodenal Mucosa ◽

Gluten Free Diet ◽

Gluten Free ◽

Autoimmune Process ◽

Duodenal Biopsies

Celiac disease (CD) is a genetically conditioned autoimmune process that appears in susceptible people. It can affect people of any age, and slightly predominates in females. It has a fairly homogenous global distribution, with an average prevalence of 1–2%, the frequency having increased in recent decades. The only effective treatment is a strict and permanent gluten-free diet (GFD), although the level of compliance is poor, at about 50% of cases. To monitor the effectiveness of the GFD, several procedures involving various approaches are employed: (a) Periodic visits by expert Nutritionists; (b) Clinical follow-up; (c) Serological time controls of specific antibodies; (d) Serial endoscopies with collection of duodenal biopsies; (e) Use of structured questionnaires; and (f) Determination of gluten peptides derived from gluten in faeces and/or urine. All of these procedures are useful when applied, alone or in combination, depending on the cases. Some patients will only need to consult to their doctors, while others will require a multidisciplinary approach to assess their compliance with the GFD. In children, normalization of duodenal mucosa was achieved in 95% of cases within two years, while it is more delayed in adults, whose mucosa take longer time (3–5 years) to heal completely.

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Comparison of Maternal and Fetal Outcomes in Parturients With and Without a Diagnosis of Gestational Diabetes

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0039-1696947 ◽

2019 ◽

Vol 41 (11) ◽

pp. 647-653 ◽

Cited By ~ 1

Author(s):

Inês Carolina Siqueira Freitas ◽

Micheli Cristiane Hintz ◽

Larissa Chaiane Orth ◽

Tamara Gonçalves da Rosa ◽

Betine Moehlecke Iser ◽

...

Keyword(s):

Family History ◽

Gestational Diabetes ◽

Statistical Significance ◽

Positive Family History ◽

Previous History ◽

Diabetes Diagnosis ◽

Fetal Outcomes ◽

Family History Of Diabetes ◽

Significant Difference ◽

History Of

Abstract Objective The present study aims to compare the maternal and fetal outcomes of parturients with and without a gestational diabetes diagnosis. Methods A case-control study including parturients with (cases) and without (control) a gestational diabetes diagnosis, who delivered at a teaching hospital in Southern Brazil, between May and August 2018. Primary and secondary data were used. Bivariate analysis and a backward conditional multivariate logistic regression were used to make comparisons between cases and controls, which were expressed by odds ratio (OR), with a 95% confidence interval (95%CI) and a statistical significance level of 5%. Results The cases (n = 47) were more likely to be 35 years old or older compared with the controls (n = 93) (p < 0.001). The cases had 2.56 times greater chance of being overweight (p = 0.014), and a 2.57 times greater chance of having a positive family history of diabetes mellitus (p = 0.01). There was no significant difference regarding weight gain, presence of a previous history of gestational diabetes, height, or delivery route. The mean weight at birth was significantly higher in the infants of mothers diagnosed with diabetes (p = 0.01). There was a 4.7 times greater chance of macrosomia (p < 0.001) and a 5.4 times greater chance of neonatal hypoglycemia (p = 0.01) in the infants of mothers with gestational diabetes. Conclusion Therefore, maternal age, family history of type 2 diabetes, obesity and pregestational overweightness are important associated factors for a higher chance of developing gestational diabetes.

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A Single Institution’s Experience of Primary Headache in Children With Celiac Disease

Journal of Child Neurology ◽

10.1177/0883073819873751 ◽

2019 ◽

Vol 35 (1) ◽

pp. 37-41 ◽

Cited By ~ 1

Author(s):

Grant L. Hom ◽

Brian L. Hom ◽

Barbara Kaplan ◽

A. David Rothner

Keyword(s):

Celiac Disease ◽

Tissue Transglutaminase ◽

Primary Headache ◽

Tension Type Headache ◽

Gluten Free Diet ◽

Gluten Free ◽

Phone Survey ◽

Type Headache ◽

The Impact ◽

Histologic Changes

Background: Few studies exist examining the frequency of primary headache in children with celiac disease and the impact of a gluten-free diet on primary headache symptomology. This study explores characteristics and frequency of headaches in children with celiac disease and response to gluten-free diet at a single institution. Methods: Medical records were reviewed for children with celiac disease confirmed by the presence of elevated tissue transglutaminase IgA levels and histologic changes consistent with the diagnosis of celiac disease on small bowel biopsy. Eligible participants were contacted via letter for participation in a phone survey regarding headaches. Phone interviews were conducted 2 weeks after notification and lasted approximately 10 minutes. Headaches were classified according to ICHD-3 criteria. Results: 247 eligible patients or their families were contacted. A total of 132 (53.44%) agreed to participate. One participant was excluded due to insufficient information provided. Overall, 51 of 131 participants had recurrent headache defined as at least 1 episode per month (39%, 95% confidence interval [CI]: 31%-47%) and 33 had migraine with or without aura (25%, 95% CI: 18%-33%). Twenty-eight had frequent tension-type headache (22%, 95% CI: 15%-29%). Thirty-two participants noted headaches before a confirmed diagnosis of celiac disease. Twenty-two of 32 participants (68.75%) noticed decreased headache frequency or intensity, or both, after starting the gluten-free diet. Conclusion: This study suggests that at least one-third of children and adolescents with celiac disease have recurrent headaches at the time of diagnosis. A gluten-free diet led to improved headache symptomology in a significant number of these patients.

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Compliance with gluten-free diet in adolescents with screening-detected celiac disease: A 5-year follow-up study

The Journal of Pediatrics ◽

10.1067/mpd.2000.105351 ◽

2000 ◽

Vol 136 (6) ◽

pp. 0841-0843 ◽

Cited By ~ 32

Author(s):

Elisabetta Fabiani ◽

Luciana Maria Taccari ◽

Ilse-Maria R[auml ]tsch ◽

Silvia Di Giuseppe ◽

Giovanni Valentino Coppa ◽

...

Keyword(s):

Celiac Disease ◽

Gluten Free Diet ◽

Gluten Free ◽

Follow Up Study

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A23 NUTRITIONAL DEFICIENCIES ARE FREQUENT IN CELIAC PATIENTS ON A GLUTEN-FREE DIET, REGARDLESS OF THE DURATION AND COMPLIANCE OF THE DIET

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz047.022 ◽

2020 ◽

Vol 3 (Supplement_1) ◽

pp. 27-28

Author(s):

A Jivraj ◽

V Connan ◽

T Balart ◽

E Ching ◽

A Marwaha ◽

...

Keyword(s):

Tissue Transglutaminase ◽

Gluten Free Diet ◽

Nutritional Deficiencies ◽

Gluten Free ◽

Dietary Compliance ◽

Persistent Symptoms ◽

Funding Agencies ◽

Adherence Test

Abstract Background The only available treatment for celiac disease (CD) is adherence to a strict gluten-free diet (GFD). CD is associated with several nutritional deficiencies, which could be explained by malabsorption when the disease is active. However, the magnitude of nutritional deficiencies in treated CD and how this is influenced by the duration and compliance of GFD is less clear. Aims We aim to evaluate the presence of nutritional deficiencies in celiac patients on short term (≤2yrs) vs long-term (>2yrs) GFD, and in those with persistent symptoms or asymptomatic in the follow up. Methods We included consecutive biopsy-proven CD patients attending the McMaster Adult Celiac Clinic. GFD adherence was assessed by validated Celiac Dietary Adherence Test (CDAT) and by anti-tissue transglutaminase antibody IgA(tTG IgA) levels. Serology, vitamins and minerals were measured in blood samples collected at enrolment. Continuous data was expressed as Median (IQR) and categorical data as proportion%. Mann-U-Whitney and Chi2 were used to compare difference between groups. Results We enrolled 171 CD patients (80% female; Median age 43 years). 76/171 (44%) of CD patients were following a GFD for over 2 years. Eighty-two percent of the patients (141/171) had persistent symptoms in the follow up and 80.7% had normal tTG IgA levels. The most common nutritional abnormalities were deficiencies in zinc (56%), iron (23%), copper (20%). Chromium was increased in 74% of patients. There were no differences in nutritional deficiencies between group of patients with short and long-term duration of GFD, nor between those strictly compliant with GFD compared to those fairly compliant (p>0.05). Conclusions Nutritional deficiencies are frequent in celiac patients on a GFD regardless of the presence of symptoms, dietary compliance or duration. The previous suggest that nutrients deficiencies may be more related to GFD nutritional inadequacy rather than malabsorption. Funding Agencies None

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