scholarly journals Extra-Intestinal Manifestations of Celiac Disease: What Should We Know in 2022?

2022 ◽  
Vol 11 (1) ◽  
pp. 258
Author(s):  
Marilena Durazzo ◽  
Arianna Ferro ◽  
Isabella Brascugli ◽  
Simone Mattivi ◽  
Sharmila Fagoonee ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Adult Population ◽  
Signs And Symptoms ◽  
Liver Function Tests ◽  
Abnormal Liver Function ◽  
Gluten Free ◽  
Atypical Symptoms ◽  
Immune Mediated ◽  
Atypical Manifestations ◽  
Small Intestinal

Celiac disease (CD) is a chronic, small-intestinal, immune-mediated enteropathy due to gluten exposition in genetically predisposed individuals. It occurs in about 1% of the population and often remains an underdiagnosed condition. This could be due to the fact that the adult population often lacks the classical signs and symptoms of CD, manifesting only atypical symptoms. In this review we analyzed the main extra-intestinal manifestations of CD which include cutaneous and endocrinological disorders, abnormal liver function tests, and neuropsychiatric features. When CD is not diagnosed and therefore is not treated with a gluten-free diet (GFD), it can predispose to severe complications, not only gastrointestinal. Thus, it is important for clinicians to quickly recognize the atypical manifestations of CD, considering that an early diagnosis can significantly impact on a patient’s prognosis.

scholarly journals Molecular Biomarkers for Celiac Disease: Past, Present and Future

2020 ◽  
Vol 21 (22) ◽  
pp. 8528
Author(s):  
Aarón D. Ramírez-Sánchez ◽  
Ineke L. Tan ◽  
B.C. Gonera-de Jong ◽  
Marijn C. Visschedijk ◽  
Iris Jonkers ◽  
...  
Keyword(s):  
Small Intestine ◽  
Celiac Disease ◽  
Early Stage ◽  
Villous Atrophy ◽  
Upper Endoscopy ◽  
Gluten Free ◽  
Non Invasive ◽  
Immune Mediated ◽  
Gastrointestinal Complaints ◽  
Small Intestinal

Celiac disease (CeD) is a complex immune-mediated disorder that is triggered by dietary gluten in genetically predisposed individuals. CeD is characterized by inflammation and villous atrophy of the small intestine, which can lead to gastrointestinal complaints, malnutrition, and malignancies. Currently, diagnosis of CeD relies on serology (antibodies against transglutaminase and endomysium) and small-intestinal biopsies. Since small-intestinal biopsies require invasive upper-endoscopy, and serology cannot predict CeD in an early stage or be used for monitoring disease after initiation of a gluten-free diet, the search for non-invasive biomarkers is ongoing. Here, we summarize current and up-and-coming non-invasive biomarkers that may be able to predict, diagnose, and monitor the progression of CeD. We further discuss how current and emerging techniques, such as (single-cell) transcriptomics and genomics, can be used to uncover the pathophysiology of CeD and identify non-invasive biomarkers.

Prevalence of Abnormal Liver Function Tests in Celiac Disease and the Effect of a Gluten-Free Diet in the US Population

2015 ◽  
Vol 110 (8) ◽  
pp. 1216-1222 ◽  
Author(s):  
Natalia E Castillo ◽  
Rohini R Vanga ◽  
Thimmaiah G Theethira ◽  
Alberto Rubio-Tapia ◽  
Joseph A Murray ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Liver Function ◽  
Liver Function Tests ◽  
Abnormal Liver Function ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Function Tests ◽  
The Us

scholarly journals Contribution of Infectious Agents to the Development of Celiac Disease

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.

scholarly journals A Patient with Typhoid Hepatitis

2021 ◽  
Vol 22 (2) ◽  
pp. 154-158
Author(s):  
M Vitanata Arfijanto ◽  
Isty Rindryastuti
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Hemorrhagic Fever ◽  
Liver Function Tests ◽  
Salmonella Typhi ◽  
Abnormal Liver Function ◽  
Grade Ii ◽  
Ig G

Typhoid hepatitis is typhoid fever accompanied by symptoms of jaundice, hepatomegaly and abnormal liver function tests. The incidence varies between 0.4% -26% of typhoid fever patients. We report a case of a 34-year-old male, presented with fever, epistaxis, gastrointestinal symptoms, thrombocytopenia and elevated AST/ ALT, thus the patient was first diagnosed as dengue hemorrhagic fever grade II. On day 9th the signs and symptoms were persisted, Ig M and Ig G Dengue was negative. Then we evaluated the virus marker for hepatitis and blood culture. The results were negative for HBsAg, anti HCV and Ig M anti HAV, but Salmonella typhi detected on blood culture. The patient was treated with ceftriaxone 1000mg bid iv and get better then discharged from hospital.

scholarly journals Sa1993 Constitutional and Functional Small Intestinal Microbiome of Patients With Celiac Disease, First Degree Relatives and Effect of Gluten Free Diet on Them

2014 ◽  
Vol 146 (5) ◽  
pp. S-349
Author(s):  
Sudarshan A. Shetty ◽  
Dhiraj P. Dhotre ◽  
Khushboo Bhatia ◽  
Anil K. Verma ◽  
Asha Mishra ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Gluten Free Diet ◽  
Intestinal Microbiome ◽  
Gluten Free ◽  
First Degree Relatives ◽  
Small Intestinal

Refractory coeliac disease a reality: views from Pakistan

2016 ◽  
Vol 47 (1) ◽  
pp. 51-53
Author(s):  
Rajesh M Mandhwani ◽  
Rajesh K Wadhwa ◽  
Syed Mudassir Laeeq ◽  
Nasir Hasan Luck ◽  
Mohammad Mubarak ◽  
...  
Keyword(s):  
Coeliac Disease ◽  
Villous Atrophy ◽  
Immunosuppressive Agents ◽  
Signs And Symptoms ◽  
Intraepithelial Lymphocytes ◽  
Response To Treatment ◽  
Gluten Free ◽  
Refractory Celiac Disease ◽  
Small Intestinal ◽  
Refractory Coeliac Disease

Refractory coeliac disease (RCD) is described as persistence or recurrence of signs and symptoms of malabsorption with small-intestinal villous atrophy despite being on a strict gluten-free diet (GFD) for more than 12 months. RCD is a diagnosis of exclusion. There are two types of RCD, based upon the immunohistochemical features (presence of intraepithelial lymphocytes), response to treatment and prognosis. The treatment of RCD includes GFD and immunosuppressive agents. We hereby present a case of refractory celiac disease type II in a young man who later went on to develop Addisonian crisis and did not survive.

scholarly journals Dermatomyositis Associated with Celiac Disease: Response to a Gluten-Free Diet

2006 ◽  
Vol 20 (6) ◽  
pp. 433-435 ◽  
Author(s):  
Min Soo Song ◽  
David Farber ◽  
Alain Bitton ◽  
Jeremy Jass ◽  
Michael Singer ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Adult Population ◽  
Gastrointestinal Symptoms ◽  
Human Leukocyte ◽  
Gluten Free Diet ◽  
Nutritional Deficiencies ◽  
Deficiency Anemia ◽  
Gluten Free ◽  
Disease Response ◽  
Vitamin Deficiencies

The association between dermatomyositis and celiac disease in children has been well documented. In the adult population, however, the association has not been clearly established. A rare case of concomitant dermatomyositis and celiac disease in a 40-year-old woman is presented. After having been diagnosed with dermatomyositis and iron deficiency anemia, this patient was referred to the gastroenterology clinic to exclude a gastrointestinal malignancy. Blood tests revealed various vitamin deficiencies consistent with malabsorption. The results of gastroscopy with duodenal biopsy were consistent with celiac disease. After she was put on a strict gluten-free diet, both nutritional deficiencies and the dermatomyositis resolved. The patient’s human leukocyte antigen haplotype study was positive for DR3 and DQ2, which have been shown to be associated with both juvenile dermatomyositis and celiac disease. It is suggested that patients with newly diagnosed dermatomyositis be investigated for concomitant celiac disease even in the absence of gastrointestinal symptoms.

scholarly journals Occult Celiac Disease in an Octogenarian Presenting with a Small Intestinal Adenocarcinoma

1994 ◽  
Vol 8 (6) ◽  
pp. 354-357 ◽  
Author(s):  
Hugh James Freeman
Keyword(s):  
Elderly Patient ◽  
Celiac Disease ◽  
Gastrointestinal Tract ◽  
Gluten Free ◽  
Duodenal Adenocarcinoma ◽  
Histological Studies ◽  
Small Bowel Carcinoma ◽  
Small Intestinal ◽  
Upper Gastrointestinal ◽  
Small Intestinal Adenocarcinoma

An 85-year-old male initially presented with an obstructed upper gastrointestinal tract associated with a duodenal adenocarcinoma. Subsequent histological studies revealed occult celiac disease, an associated condition that otherwise would not have been recognized in this elderly patient. The celiac disease responded to a gluten-free diet, even in the presence of an intestinal adenocarcinoma. This report suggests that celiac disease and small bowel carcinoma may coexist more frequently than is appreciated.

Celiac Disease and the Gluten-Free Diet: Consequences and Recommendations for Improvement

2015 ◽  
Vol 33 (2) ◽  
pp. 175-182 ◽  
Author(s):  
Thimmaiah G. Theethira ◽  
Melinda Dennis
Keyword(s):  
Celiac Disease ◽  
Critical Role ◽  
Nutrition Therapy ◽  
Gluten Free Diet ◽  
Nutritional Deficiencies ◽  
Gluten Free ◽  
Immune Mediated ◽  
Macro And Micronutrients ◽  
Medical Nutrition

Background: Celiac disease (CD) is a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically susceptible individuals. CD-related enteropathy leads to multiple nutritional deficiencies involving macro- and micronutrients. Currently, medical nutrition therapy consisting of the gluten-free diet (GFD) is the only accepted treatment for CD. Key Messages: The GFD is the cornerstone of treatment for CD. Prior published studies have concluded that maintenance of the GFD results in improvement of the majority of nutritional deficiencies. In the past, counseling for CD focused mainly on the elimination of gluten in the diet. However, the GFD is not without its inadequacies; compliance to the GFD may result in certain deficiencies such as fiber, B vitamins, iron, and trace minerals. Paucity of fortified gluten-free foods may be responsible for certain deficiencies which develop on the GFD. Weight gain and obesity have been added to the list of nutritional consequences while on the GFD and have been partially attributed to hypercaloric content of commercially available gluten-free foods. Follow-up of patients diagnosed with CD after starting the GFD has been reported to be irregular and, hence, less than ideal. Conclusions: Monitoring of the nutritional status using blood tests and use of appropriate gluten-free supplementation are integral components in the management of CD. The ideal GFD should be nutrient-dense with naturally gluten-free foods, balanced with macro- and micronutrients, reasonably priced, and easily accessible. Rotation of the pseudo-cereals provides a good source of complex carbohydrates, protein, fiber, fatty acids, vitamins and minerals. Fortification/enrichment of commonly consumed gluten-free commercial grain products should be encouraged. Dietitians specializing in CD play a critical role in the education and maintenance of the GFD for patients with CD.

scholarly journals The Evolving Landscape of Biomarkers in Celiac Disease: Leading the Way to Clinical Development

2021 ◽  
Vol 12 ◽  
Author(s):  
Glennda Smithson ◽  
Jenifer Siegelman ◽  
Toshihiko Oki ◽  
Joseph R. Maxwell ◽  
Daniel A. Leffler
Keyword(s):  
Celiac Disease ◽  
Peripheral Blood Cell ◽  
Clinical Development ◽  
Intestinal Damage ◽  
Gluten Free ◽  
Histological Changes ◽  
Specific Patient ◽  
Cell Responses ◽  
Immune Mediated ◽  
Duodenal Biopsies

Celiac disease is a common immune-mediated disease characterized by abnormal T-cell responses to gluten. For many patients, symptoms and intestinal damage can be controlled by a gluten-free diet, but, for some, this approach is not enough, and celiac disease progresses, with serious medical consequences. Multiple therapies are now under development, increasing the need for biomarkers that allow identification of specific patient populations and monitoring of therapeutic activity and durability. The advantage of identifying biomarkers in celiac disease is that the underlying pathways driving disease are well characterized and the histological, cellular, and serological changes with gluten response have been defined in gluten challenge studies. However, there is room for improvement. Biomarkers that measure histological changes require duodenal biopsies and are invasive. Less invasive peripheral blood cell and cytokine biomarkers are transient and dependent upon gluten challenge. Here, we discuss established biomarkers and new approaches for biomarkers that may overcome current limitations.

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