2628 Incidental Isolated Small Intestinal Melanoma in a Patient With Newly Diagnosed Celiac Disease

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.

Download Full-text

The Prevalence of Anti-Zein Antibodies: A Comparative Study between Celiac Disease and Irritable Bowel Syndrome

Nutrients ◽

10.3390/nu13020649 ◽

2021 ◽

Vol 13 (2) ◽

pp. 649

Author(s):

Luis Alberto Sánchez-Vargas ◽

Karina Guadalupe Hernández-Flores ◽

Francisco Javier Cabrera-Jorge ◽

José María Remes-Troche ◽

Job Reyes-Huerta ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Celiac Disease ◽

Gastrointestinal Disorder ◽

Newly Diagnosed ◽

Disease Group ◽

Immune Mediated ◽

Healthy Control ◽

Gliadin Peptides ◽

Irritable Bowel ◽

First Time

Celiac disease (CD) is a chronic immune-mediated enteropathy triggered by exposure to dietary gluten in genetically predisposed individuals. In contrast, irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder affecting the large intestine, without an autoimmune component. Here, we evaluated the prevalence of IgA and IgG antibodies to maize zeins (AZA) in patients with CD and IBS. Using an in-house ELISA assay, the IgA and IgG anti-zein antibodies in the serum of 37 newly diagnosed CD (16 biopsy proved and 21 serological diagnosis) and 375 IBS patients or 302 healthy control (HC) subjects were measured. Elevated levels of IgA AZA were found in CD patients compared with IBS patients (p < 0.01) and HC (p < 0.05). CD patients had the highest prevalence (35.1%), followed by IBS (4.3%) and HCs (2.3%) (p < 0.0001). IgG AZA antibodies were not found in any CD patients, IBS patients, or HC subjects. A significant positive correlation was found between IgA AZA with IgA anti-gliadin (AGA, r = 0.34, p < 0.01) and IgA anti-deaminated gliadin peptides (DGP, r = 0.42, p < 0.001) in the celiac disease group. Taken together, our results show for the first time a higher prevalence of AZA IgA antibodies in newly diagnosed CD patients than in IBS patients, confirming a biased immune response to other gliadin-related prolamins such as maize zeins in genetically susceptible individuals.

Download Full-text

Contribution of Infectious Agents to the Development of Celiac Disease

Microorganisms ◽

10.3390/microorganisms9030547 ◽

2021 ◽

Vol 9 (3) ◽

pp. 547

Author(s):

Daniel Sánchez ◽

Iva Hoffmanová ◽

Adéla Szczepanková ◽

Věra Hábová ◽

Helena Tlaskalová-Hogenová

Keyword(s):

Celiac Disease ◽

Intestinal Mucosa ◽

Wheat Gluten ◽

Small Intestinal Mucosa ◽

Beneficial Effects ◽

Immune Mediated ◽

Healthy State ◽

Food Antigens ◽

Small Intestinal ◽

And Function

The ingestion of wheat gliadin (alcohol-soluble proteins, an integral part of wheat gluten) and related proteins induce, in genetically predisposed individuals, celiac disease (CD), which is characterized by immune-mediated impairment of the small intestinal mucosa. The lifelong omission of gluten and related grain proteins, i.e., a gluten-free diet (GFD), is at present the only therapy for CD. Although a GFD usually reduces CD symptoms, it does not entirely restore the small intestinal mucosa to a fully healthy state. Recently, the participation of microbial components in pathogenetic mechanisms of celiac disease was suggested. The present review provides information on infectious diseases associated with CD and the putative role of infections in CD development. Moreover, the involvement of the microbiota as a factor contributing to pathological changes in the intestine is discussed. Attention is paid to the mechanisms by which microbes and their components affect mucosal immunity, including tolerance to food antigens. Modulation of microbiota composition and function and the potential beneficial effects of probiotics in celiac disease are discussed.

Download Full-text

Circulating Extracellular Vesicles, A Novel Mechanism of Endocrine Cellular Cross-Talk, are Increased in Newly Diagnosed Celiac Disease Patients

Gastroenterology ◽

10.1016/s0016-5085(17)30590-5 ◽

2017 ◽

Vol 152 (5) ◽

pp. S71

Author(s):

Konstantinos Efthymakis ◽

Giuseppina Bologna ◽

Paola Lanuti ◽

Angelo Milano ◽

Francesco Laterza ◽

...

Keyword(s):

Celiac Disease ◽

Extracellular Vesicles ◽

Cross Talk ◽

Newly Diagnosed

Download Full-text

Small intestinal permeability to mannitol, lactulose, and polyethylene glycol 400 in celiac disease

Digestive Diseases and Sciences ◽

10.1007/bf01318423 ◽

1984 ◽

Vol 29 (9) ◽

pp. 809-816 ◽

Cited By ~ 77

Author(s):

S. O. Ukabam ◽

B. T. Cooper

Keyword(s):

Celiac Disease ◽

Polyethylene Glycol ◽

Intestinal Permeability ◽

Polyethylene Glycol 400 ◽

Small Intestinal

Download Full-text

Collagenous Sprue: A Rare, Severe Small-Bowel Malabsorptive Disorder

Archives of Pathology & Laboratory Medicine ◽

10.5858/2010-0028-rs.1 ◽

2011 ◽

Vol 135 (6) ◽

pp. 803-809

Author(s):

Xiangrong Zhao ◽

Rebecca L. Johnson

Keyword(s):

Celiac Disease ◽

Medical Literature ◽

Case Reports ◽

Disease Entity ◽

Review Of The Literature ◽

Molecular Features ◽

Refractory Sprue ◽

Exact Etiology ◽

Sporadic Cases ◽

Small Intestinal

Abstract Collagenous sprue is a severe malabsorptive disorder, histologically characterized by small intestinal villous and crypt atrophy, and a subepithelial collagen deposit, thicker than 12 µm, that entraps lamina propria cellular elements. Collagenous sprue is a rare disease entity, with only about 60 sporadic cases reported worldwide since it was first described in 1947. Its exact etiology is still under investigation, and its relationship with classic celiac disease and other refractory, spruelike intestinal disorders remains controversial. Two larger-scale studies, in 2009, brought new insights into this elusive, yet emerging, topic. Here, we present a review of the literature on the possible etiology of collagenous sprue, its proposed links to classic celiac disease and to refractory sprue, and its clinical, biochemical, histologic, and molecular features. To our knowledge, all case reports on collagenous sprue in the medical literature to date are summarized.

Download Full-text

INCREASED TISSUE TRANSGLUTAMINASE LEVELS ARE ASSOCIATED WITH INCREASED EPILEPTIFORM ACTIVITY IN ELECTROENCEPHALOGRAPHY AMONG PATIENTS WITH CELIAC DISEASE

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032015000400005 ◽

2015 ◽

Vol 52 (4) ◽

pp. 272-277 ◽

Cited By ~ 3

Author(s):

Sedat IŞIKAY ◽

Şamil HIZLI ◽

Serkan ÇOŞKUN ◽

Kutluhan YILMAZ

Keyword(s):

Celiac Disease ◽

Tissue Transglutaminase ◽

Pearson Correlation ◽

Epileptiform Activity ◽

Control Group ◽

Healthy Children ◽

Newly Diagnosed ◽

Laboratory Findings ◽

Significant Difference ◽

Medical Histories

Background - Celiac disease is an autoimmune systemic disorder in genetically predisposed individuals precipitated by gluten ingestion. Objective - In this study, we aimed to determine asymptomatic spike-and-wave findings on electroencephalography in children with celiac disease. Methods - A total of 175 children with the diagnosis of celiac disease (study group) and 99 age- and sex-matched healthy children as controls (control group) were included in the study. In order to determine the effects of gluten free diet on laboratory and electroencephalography findings, the celiac group is further subdivided into two as newly-diagnosed and formerly-diagnosed patients. Medical histories of all children and laboratory findings were all recorded and neurologic statuses were evaluated. All patients underwent a sleep and awake electroencephalography. Results - Among 175 celiac disease patients included in the study, 43 were newly diagnosed while 132 were formerly-diagnosed patients. In electroencephalography evaluation of patients the epileptiform activity was determined in 4 (9.3%) of newly diagnosed and in 2 (1.5%) of formerly diagnosed patients; on the other hand the epileptiform activity was present in only 1 (1.0%) of control cases. There was a statistically significant difference between groups in regards to the presence of epileptiform activity in electroencephalography. Pearson correlation analysis revealed that epileptiform activity in both sleep and awake electroencephalography were positively correlated with tissue transglutaminase levels (P=0.014 and P=0.019, respectively). Conclusion - We have determined an increased epileptiform activity frequency among newly-diagnosed celiac disease patients compared with formerly-diagnosed celiac disease patients and control cases. Moreover the tissue transglutaminase levels were also correlated with the presence of epileptiform activity in electroencephalography. Among newly diagnosed celiac disease patients, clinicians should be aware of this association and be alert about any neurological symptoms.

Download Full-text