Celiac Disease Diagnosed through Screening Programs in At-Risk Adults Is Not Associated with Worse Adherence to the Gluten-Free Diet and Might Protect from Osteopenia/Osteoporosis

Screening strategies to detect celiac disease (CD) in at-risk subjects are of paramount importance to prevent the possible long-term complications of this condition. It is therefore of strategic relevance to understand whether patients diagnosed through screening follow a strict gluten-free diet (GFD), as the non-compliance to this diet can make screening efforts pointless. Currently, no studies have verified whether CD patients diagnosed in their adulthood are adhering to the GFD years after the diagnosis. We retrospectively evaluated the medical records of 750 CD patients diagnosed in our center during January 2004–December 2013 to verify differences between screening detected and clinically diagnosed patients. The groups shared a similar adherence to the GFD (91.2 versus 89.8%, p = 0.857). Moreover, the rates of non-responsive CD, GFD-induced metabolic alterations, and persistence in controls were also similar. Instead, screening-detected patients had a significantly lower rate of osteopenia/osteoporosis at diagnosis (31.3 versus 46%, p < 0.001). In conclusion, screening strategies for CD in at-risk groups should be encouraged even in the adult population. Patients diagnosed through these strategies had no additional problems compared to those diagnosed for clinical suspicion and might benefit from a protective effect against metabolic bone disease.

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Celiac Disease Revisited

GE Portuguese Journal of Gastroenterology ◽

10.1159/000514716 ◽

2021 ◽

pp. 1-14

Author(s):

João Calado ◽

Mariana Verdelho Machado

Keyword(s):

Celiac Disease ◽

Systemic Disease ◽

Human Leukocyte ◽

Risk Groups ◽

Gluten Free Diet ◽

Gluten Free ◽

Serological Tests ◽

Leukocyte Antigen ◽

Human Leukocyte Antigen Haplotype ◽

Circulating Autoantibodies

Celiac disease (CD) is a systemic disease triggered by gluten ingestion in genetically predisposed individuals. It manifests primarily as an autoimmune enteropathy associated with specific circulating autoantibodies and a human leukocyte antigen haplotype (HLA-DQ2 or HLA-DQ8). It afflicts roughly 1% of the population, though the majority of patients remain undiagnosed. Diarrhea and malabsorption are classic manifestations of CD; however, both children and adults can be paucisymptomatic and present extraintestinal manifestations such as anemia, osteoporosis, and abnormal liver tests. CD screening is not recommended for the general population, and it should be focused on high-risk groups. CD diagnosis is challenging and relies on serological tests, duodenal histology, and genetic testing. Particularly difficult presentations to manage are seronegative patients, seropositive patients without villus atrophy, and patients who have started a gluten-free diet before the diagnostic workup. The only proven treatment is a lifelong gluten-free diet. We present an in-depth review on the physiopathology and management of CD, with a particular emphasis on diagnostic challenges.

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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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A Phase I Study to Determine Safety, Tolerability and Bioactivity of Nexvax2® in HLA DQ2+ Volunteers With Celiac Disease Following a Long-Term, Strict Gluten-Free Diet

Gastroenterology ◽

10.1016/s0016-5085(11)61794-0 ◽

2011 ◽

Vol 140 (5) ◽

pp. S-437-S-438 ◽

Cited By ~ 23

Author(s):

Gregor J. Brown ◽

James Daveson ◽

Joanne K. Marjason ◽

Rose A. Ffrench ◽

Danielle Smith ◽

...

Keyword(s):

Celiac Disease ◽

Phase I ◽

Phase I Study ◽

Gluten Free Diet ◽

Gluten Free ◽

Hla Dq2

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S2041 Improved Performance of Celiac Disease-Related Serology Tests in Predicting the Degree of Patients' Compliance With Long-Term Gluten-Free Diet. New Cut-Offs are Necessary

Gastroenterology ◽

10.1016/s0016-5085(10)61413-8 ◽

2010 ◽

Vol 138 (5) ◽

pp. S-307

Author(s):

Fabio D. Nachman ◽

Emilia Sugai ◽

Horacio Vázquez ◽

Andrea F. Gonzalez ◽

Paola J. Andrenacci ◽

...

Keyword(s):

Celiac Disease ◽

Gluten Free Diet ◽

Gluten Free ◽

Improved Performance

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Persistent Duodenal Intraepithelial Lymphocytosis Despite a Long-Term Strict Gluten-Free Diet in Celiac Disease

The American Journal of Gastroenterology ◽

10.1038/ajg.2012.220 ◽

2012 ◽

Vol 107 (10) ◽

pp. 1563-1569 ◽

Cited By ~ 69

Author(s):

Ilus Tuire ◽

Lähdeaho Marja-Leena ◽

Salmi Teea ◽

Haimila Katri ◽

Partanen Jukka ◽

...

Keyword(s):

Celiac Disease ◽

Gluten Free Diet ◽

Gluten Free ◽

Intraepithelial Lymphocytosis

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Urinary nitric oxide metabolites in children with celiac disease after long-term consumption of oats-containing gluten-free diet

Scandinavian Journal of Gastroenterology ◽

10.3109/00365521.2014.946081 ◽

2014 ◽

Vol 49 (11) ◽

pp. 1311-1317 ◽

Cited By ~ 6

Author(s):

Dimitrios Tapsas ◽

Karin Fälth-Magnusson ◽

Lotta Högberg ◽

Tony Forslund ◽

Tommy Sundqvist ◽

...

Keyword(s):

Nitric Oxide ◽

Celiac Disease ◽

Gluten Free Diet ◽

Gluten Free ◽

Nitric Oxide Metabolites

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

Canadian Journal of Gastroenterology ◽

10.1155/2006/574074 ◽

2006 ◽

Vol 20 (6) ◽

pp. 433-435 ◽

Cited By ~ 20

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.

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