Cystic fibrosis and celiac disease - multifaceted and similar

Folia Medica ◽  
2013 ◽  
Vol 55 (3-4) ◽  
pp. 87-89 ◽  
Author(s):  
Nelly D. Genkova ◽  
Ivan V. Yankov ◽  
Miroslava N. Bosheva ◽  
Benjamin L. Anavi ◽  
Dafina G. Grozeva ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Celiac Disease ◽  
Chronic Diarrhea ◽  
Serological Test ◽  
Clinical Manifestations ◽  
Duodenal Mucosa ◽  
Gluten Free ◽  
Immunological Tests ◽  
Targeted Screening ◽  
Sweat Tests

ABSTRACT Celiac disease and cystic fibrosis share a number of clinical manifestations. The comorbidity rate of these diseases is low: 1:200000. We present a case of a child aged 1 year and 5 months, born to a mixed-marriage parents, with concomitant cystic fibrosis and celiac disease manifesting initially with chronic diarrhea. Diagnosis of cystic fibrosis was made on the basis of changes in pulmonogram and three positive sweat tests with the malabsorption managed. Celiac disease was demonstrated through immunological tests (serological test of anti-transglutaminase antibodies of IgA class), histological tests (altered duodenal mucosa) and the therapeutic effect of a gluten-free diet. This case is the first ever reported case of a child with concomitant cystic fibrosis and celiac disease in Bulgaria. The case suggests the need for targeted screening for celiac disease in children with cystic fibrosis.

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

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1777 ◽  
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.

scholarly journals Association between Endoscopic Findings Vs. Serology Findings of Patients with Suspected Celiac Disease

2021 ◽  
pp. 301-307
Author(s):  
Anwar Hussain Abbasi ◽  
Khawaja Ishfaq Ahmed ◽  
Nadeem Yousuf ◽  
Mahjabeen Fatima Qureshi ◽  
Muhammad Shahzeb Shaikh ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Chronic Diarrhea ◽  
Villous Atrophy ◽  
Clinical Manifestations ◽  
Final Analysis ◽  
Normal Mucosa ◽  
Diagnostic Value ◽  
Endoscopic Evaluation ◽  
Drug Induced ◽  
Endoscopic Findings

Objective: To determine the association between endoscopic findings vs. serology findings of patients with suspected celiac disease Methods: All the suspected cases (based on their clinical manifestations) of celiac disease were initially recruited having age >14 years and <40 years of both gender. Patients who did not willing to participate, patients already taking gluten diet for more than 3 months, patients with other causes of chronic diarrhea and alternate diagnosis like thyrotoxicosis, whipple’s disease, giardiasis, patients with drug induced diarrhea, patients in whom we cannot perform endoscopy, pregnant women, and patients already diagnosed cases of celiac disease were excluded from this study. Celiac disease was confirmed based on positive anti-tTG antibodies. Endoscopic evaluation of duodenum was performed in all positive cases. Results: A total of 50 patients were recruited for final analysis. Diagnostic accuracy of endoscopy was 34.6%. Young population (31.14±6.07 years) with females predominance (72%, n=36) were more common than males. The most common symptoms were presence of chronic diarrhea (74%, n=37) followed by abdominal pain (52%, n=26), nausea & vomiting (34%, n=17), and least common was presence of constipation (2%, n=1). On endoscopic evaluation, out of 50 positive anti-tTG antibodies cases, 24 had normal mucosa while partial villous atrophy observed in 15 (30%) cases and total villous atrophy observed in 11 cases (22%). Conclusions: Celiac disease was more prevalent in young females and patients usually presents with history of chronic diarrhea. Anti-tTG antibodies have more diagnostic value than duodenal endoscopy. Villous atrophy was found in more than 50% of the patients who were diagnosed with celiac disease.

scholarly journals Clinical and Paraclinical Screening for Celiac Disease in Children with Intractable Epilepsy

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Golnaz Ghazizadeh Esslami ◽  
Bahar Allahverdi ◽  
Reza Shervin Badv ◽  
Morteza Heidari ◽  
Nahid Khosroshahi ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Serological Test ◽  
Venous Blood ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Intractable Epilepsy ◽  
Underlying Disease ◽  
Growth Disorders ◽  
Serological Tests ◽  
Cross Sectional

Background. Celiac disease is the inflammatory entropy caused by hypersensitivity to gluten, which occurs in susceptible individuals. Some studies have suggested a link between celiac disease and epilepsy in children. Our aim was to screen for clinical and paraclinical features of celiac disease in children with intractable epilepsy. Methods. This was a cross-sectional study. Children aged 2 to 18 years with refractory epilepsy that referred to the pediatric neurology clinic within one year (2018–2019) were enrolled. Demographic and clinical characteristics of patients, especially clinical manifestations of celiac disease, were recorded in a questionnaire. A venous blood sample was sent to determine the total IgA, anti-tTG (IgA), and anti-endomysial antibody (IgA). Endoscopy was performed in cases where the celiac serological test was positive. Results. Seventy children with idiopathic drug-resistant epilepsy (44 boys) were evaluated. The height-for-age index was 49.2% and the weight-for-age index was 38.2% less than normal. Constipation (48.6%), anorexia (25.7%), and abdominal pain (21.4%) were the most common gastrointestinal symptoms. Celiac serological tests were negative in all children. Therefore, endoscopy and bowel biopsy were not performed in any case. Conclusion. Celiac disease was not found in any patient with intractable epilepsy. Gastrointestinal symptoms and growth disorders in this group may be related to the underlying disease or medications and not to celiac disease.

scholarly journals Evaluation of Efficacy and Adherence to Gluten-Free Diet in Patients with Celiac Disease

2018 ◽  
Author(s):  
Luis Rodrigo ◽  
Isabel Perez-Martinez ◽  
Eugenia Lauret-Braña ◽  
Adolfo Suarez-Gonzalez
Keyword(s):  
Celiac Disease ◽  
Multidisciplinary Approach ◽  
Duodenal Mucosa ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Autoimmune Process ◽  
Specific Antibodies ◽  
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 with it is poor, at about 50% of cases. To monitor the effectiveness of the GFD, several procedures involving various approaches are employed: a) periodic interviews by nutritionists; b) clinical follow-up; c) serological controls of specific antibodies; d) endoscopies with collection of duodenal biopsies; e) structured questionnaires; f) determination of gluten peptides derived from gluten in feces 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 2 years, while it is more delayed in adults, whose mucosa take longer to heal completely.

The Coexistence of Cystic Fibrosis and Celiac Disease

PEDIATRICS ◽  
1976 ◽  
Vol 57 (5) ◽  
pp. 715-721
Author(s):  
Aubrey J. Katz ◽  
Z. Myron Falchuk ◽  
Harry Shwachman
Keyword(s):  
Cystic Fibrosis ◽  
Celiac Disease ◽  
Organ Culture ◽  
Intestinal Mucosa ◽  
In Vitro Model ◽  
Duodenal Mucosa ◽  
Common Type ◽  
The Other ◽  
Vitro Model

Two patients with cystic fibrosis (CF) who subsequently developed celiac disease (CD) are described. Since organ culture of intestinal mucosa has been used to establish an in vitro model for the study of CD, we utilized this opportunity to determine whether duodenal mucosa obtained from each of these two patients and their immediate families differed in its organ culture behavior from mucosa obtained from patients with CD alone. Additionally, as specific HL-A types are associated with CD, we used HL-A typing to determine whether the two patients with CF-CD differed genetically from patients with CD alone. One of our patients was HL-A8, the most common type associated with CD; the other was HL-A12, as are many of the non-HL-A8 celiac patients. The response in organ culture of the mucosa of these two patients was the same as the response in organ culture of the mucosa from patients with CD alone. These and other data suggest that CD occurring in patients with CF is no different than CD occurring alone.

An Attempt of Specific Desensitising Treatment with Gliadin in Celiac Disease

2005 ◽  
Vol 18 (4) ◽  
pp. 709-714 ◽  
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.

scholarly journals Seronegative Intestinal Villous Atrophy: A Diagnostic Challenge

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Cláudio Martins ◽  
Cristina Teixeira ◽  
Suzane Ribeiro ◽  
Daniel Trabulo ◽  
Cláudia Cardoso ◽  
...  
Keyword(s):  
Weight Loss ◽  
Celiac Disease ◽  
Chronic Diarrhea ◽  
Villous Atrophy ◽  
Gluten Free ◽  
Diagnostic Challenge ◽  
Drug Induced ◽  
High Index Of Suspicion ◽  
Involuntary Weight Loss ◽  
Intraepithelial Lymphocytosis

Celiac disease is the most important cause of intestinal villous atrophy. Seronegative intestinal villous atrophy, including those that are nonresponsive to a gluten-free diet, is a diagnostic challenge. In these cases, before establishing the diagnosis of seronegative celiac disease, alternative etiologies of atrophic enteropathy should be considered. Recently, a new clinical entity responsible for seronegative villous atrophy was described—olmesartan-induced sprue-like enteropathy. Herein, we report two uncommon cases of atrophic enteropathy in patients with arterial hypertension under olmesartan, who presented with severe chronic diarrhea and significant involuntary weight loss. Further investigation revealed intestinal villous atrophy and intraepithelial lymphocytosis. Celiac disease and other causes of villous atrophy were ruled out. Drug-induced enteropathy was suspected and clinical improvement and histologic recovery were verified after olmesartan withdrawal. These cases highlight the importance for clinicians to maintain a high index of suspicion for olmesartan as a precipitant of sprue-like enteropathy.

scholarly journals Non-celiac wheat sensitivity: rationality and irrationality of a gluten-free diet in individuals affected with non-celiac disease: a review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Consolato Sergi ◽  
Vincenzo Villanacci ◽  
Antonio Carroccio
Keyword(s):  
Celiac Disease ◽  
Duodenal Mucosa ◽  
Gluten Free Diet ◽  
Diagnostic Process ◽  
Gluten Free ◽  
Accurate Analysis ◽  
Superficial Epithelium ◽  
Wheat Sensitivity ◽  
Irritable Bowel ◽  
The Relationship

AbstractNon-celiac gluten or wheat sensitivity (NCWS) is a “clinical entity induced by the ingestion of wheat leading to intestinal and/or extraintestinal symptoms that improve once the wheat-containing foodstuff is removed from the diet, and celiac disease and wheat allergy have been excluded”. This mostly accepted definition raises several points that remain controversial on this condition. In the present review, the authors summarize the most recent advances in the clinic and research on NCWS through an accurate analysis of different studies. We screened PubMed, Medline, Embase, and Scopus using the keywords “non-celiac gluten sensitivity”, “non-celiac wheat sensitivity”, and “diagnosis”. We would like to emphasize two main points, including (A) the controversial clinical and etiological aspects in different trials and experiences with particular attention to the Salerno criteria for the diagnosis of NCWS and (B) the histological aspects. The etiology of NCWS remains controversial, and the relationship with irritable bowel syndrome is obscure. Histologically, the duodenal mucosa may show a variable pattern from unremarkable to a slight increase in the number of T lymphocytes in the superficial epithelium of villi. The endorsement of this disease is based on a positive response to a gluten-free diet for a limited period, followed by the reappearance of symptoms after gluten challenge. The Salerno expert criteria may help to diagnose NCWS accurately. Social media and inaccurate interpretation of websites may jeopardize the diagnostic process if individuals self-label as gluten intolerant.

scholarly journals Celiac Disease in Patients with Cystic Fibrosis-Related Bone Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Melissa S. Putman ◽  
Alexandra Haagensen ◽  
Isabel Neuringer ◽  
Leonard Sicilian
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Cystic Fibrosis ◽  
Vitamin D ◽  
Celiac Disease ◽  
General Population ◽  
Bone Disease ◽  
Gluten Free ◽  
Mineral Density ◽  
The Past

Both cystic fibrosis (CF) and celiac disease can cause low bone mineral density (BMD) and fractures. Celiac disease may occur at a higher frequency in patients with CF than the general population, and symptoms of these conditions may overlap. We report on two patients presenting with CF-related bone disease in the past year who were subsequently found to have concurrent celiac disease. Because adherence to a gluten-free diet may improve BMD in patients with celiac disease, this could have important implications for treatment. Clinicians should consider screening for celiac disease in patients with CF who have low BMD, worsening BMD in the absence of other risk factors, and/or difficult to treat vitamin D deficiency.

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