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villous atrophy

Luca Elli, Francesca Ferretti, Stefania Orlando, Maurizio Vecchi, Erika Monguzzi, Leda Roncoroni, Detlef Schuppan
Celiac disease (CD) is the most common autoimmune enteropathy worldwide. In CD, dietary gluten triggers a T cell driven small intestinal inflammation in a subset of genetically predisposed subjects, expressing the HLA DQ2 and/or DQ8 genes on their antigen presenting cells. HLA DQ2/DQ8 can bind gluten peptides after their prior modification by the CD autoantigen, tissue transglutaminase (TG2). This process leads to the activation of gluten reactive T cells, small bowel villous atrophy, crypt hyperplasia and intraepithelial lymphocytosis, the histological hallmarks of CD...
December 5, 2018: European Journal of Internal Medicine
Minna Hietikko, Outi Koskinen, Kalle Kurppa, Kaija Laurila, Päivi Saavalainen, Teea Salmi, Tuire Ilus, Heini Huhtala, Katri Kaukinen, Katri Lindfors
BACKGROUND: In coeliac disease, ingestion of gluten induces the production of transglutaminase 2 (TG2)-targeted autoantibodies by TG2-specific plasma cells present at high frequency in the small intestinal mucosa in untreated disease. During treatment with a gluten-free diet (GFD), the number of these cells decreases considerably. It has not been previously investigated whether the cells are also present prior to development of villous atrophy, or in non-responsive patients and those with dietary lapses...
December 6, 2018: BMC Immunology
Javier Lucas Ramos, Pedro de María Pallarés, Álvaro Pezzela Risueño
Mycophenolate mofetil (MMF) is an immunosuppressive agent that is used in transplanted patients, with frequent gastrointestinal adverse effects. We report the case of a patient, under chronic therapy with mycophenolate mofetil , during a diagnostic workup for a chronic diarrhea, which presents a duodenal villous atrophy ( VA) with negative celiac serology, which is a diagnostic challenge. VA secondary to MMF is a very unusual adverse effect. Just a few cases have been reported in the literature.
December 4, 2018: Revista Española de Enfermedades Digestivas
Neha Berry, Jahangeer Basha, Neelam Varma, Subhash Varma, Kaushal Kishor Prasad, Kim Vaiphei, Narendra Dhaka, Saroj K Sinha, Rakesh Kochhar
Background and Aims: Anemia is one of the most common extraintestinal manifestations of celiac disease (CD), with iron deficiency anemia (IDA) being the predominant cause. However, anemia in CD can have varied etiologies, including mixed nutritional deficiency. We aimed to study the prevalence and etiology of anemia in CD in a north Indian population. Methods: In this prospective observational study, consecutive patients with documented CD between January 2012 and December 2013 were included, and all patients underwent detailed clinical assessment; hematological investigations including iron profile, serum folate, and vitamin B12 levels; and esophageoduodenoscopy with duodenal biopsies for histopathological examination...
October 2018: JGH open: an open access journal of gastroenterology and hepatology
Claire L Jansson-Knodell, Isabel A Hujoel, Colin P West, Veena Taneja, Larry J Prokop, Alberto Rubio-Tapia, Joseph A Murray
BACKGROUND AND AIMS: A higher proportion of female vs male patients receive a diagnosis of celiac disease. Little is known about sex-based differences in the prevalence of celiac disease in undiagnosed populations. We aimed to address this knowledge gap with a systematic review and meta-analysis. METHODS: We searched MEDLINE, Embase, Cochrane, and Scopus databases through 2017 for studies of screen-detected or undiagnosed celiac disease. Our final analysis included studies that included screening and confirmatory tests (either second serologic analysis or a small intestine biopsy) and provided information on sex of participants...
November 15, 2018: Clinical Gastroenterology and Hepatology
Pavel Frühauf, N Nabil El-Lababidi, Peter Szitányi
Celiac disease can be defined as a small bowel disorder characterized by mucosal inflammation, villous atrophy and crypt hyperplasia, which occurs upon exposure to dietary gluten and which demonstrates improvement after withdrawal of gluten from the diet. Keywords: celiac disease, children, adolescents.
2018: Casopís Lékar̆ů C̆eských
Manuel Valero, Gladys Bravo-Velez, Roberto Oleas, Miguel Puga-Tejada, Miguel Soria-Alcívar, Haydee Alvarado Escobar, Jorge Baquerizo-Burgos, Hannah Pitanga-Lukashok, Carlos Robles-Medranda
Background/Aims: Capsule endoscopy is a diagnostic method for evaluating the small bowel lumen and can detect undiagnosed lesions. The aim of this study was to evaluate the diagnostic yield and clinical impact of capsule endoscopy in patients with refractory diarrhea-predominant irritable bowel syndrome and functional abdominal pain. Methods: This study involved a retrospective analysis of prospectively collected data, maintained in a database. Patients with refractory diarrhea-predominant irritable bowel syndrome and functional abdominal pain within the period of March 2012 to March 2014 were included...
November 16, 2018: Clinical Endoscopy
Vito Domenico Corleto, Vincenza Patrizia Di Marino, Gloria Galli, Giulio Antonelli, Chiara Coluccio, Arcangelo Di Cerbo, Stefania Uccini, Bruno Annibale
BACKGROUND: The diagnosis of Coeliac disease (CD) requires a combination of sign/symptoms, positivity of specific antibodies and duodenal histological evidence of villous atrophy. Duodenal villous atrophy, despite representing the CD landmark, is not specific since it is found in many gastrointestinal disorders. Giardiasis is one of the most common human intestinal protozoan infestations in industrialized countries whose histological duodenal mucosa damage could mimic that of CD. The present report shows how a wise clinical and laboratory assessment led us shortly to a correct diagnosis...
November 3, 2018: BMC Gastroenterology
Itay Tokatly Latzer, Liat Lerner-Geva, Daniel Stein, Batia Weiss, Orit Pinhas-Hamiel
PURPOSE: Celiac disease (CD) is a chronic immune-mediated systemic disease characterized by inflammation and villous atrophy of the small intestine. A strict, lifelong gluten-free diet (GFD) is the only treatment for CD. Disordered eating behaviors (DEBs) prevail in adolescence and young adulthood, and confer a risk of developing into full-blown eating disorders. The aims of the current study were to assess the incidence and risk factors for DEBs among individuals with CD, and to examine an association between adherence to GFD and DEBs...
October 27, 2018: Eating and Weight Disorders: EWD
Hey-Long Ching, Melissa F Hale, Matthew Kurien, Jennifer A Campbell, Stefania Chetcuti Zammit, Ailish Healy, Victoria Thurston, John M Hebden, Reena Sidhu, Mark E McAlindon
BACKGROUND:  Small-bowel capsule endoscopy is advocated and repeat upper gastrointestinal (GI) endoscopy should be considered for evaluation of recurrent or refractory iron deficiency anemia (IDA). A new device that allows magnetic steering of the capsule around the stomach (magnetically assisted capsule endoscopy [MACE]), followed by passive small-bowel examination might satisfy both requirements in a single procedure. METHODS:  In this prospective cohort study, MACE and esophagogastroduodenoscopy (EGD) were performed in patients with recurrent or refractory IDA...
October 25, 2018: Endoscopy
Rok Seon Choung, Shahryar Khaleghi Rostamkolaei, Josephine M Ju, Eric V Marietta, Carol T Van Dyke, J J Rajasekaran, Vasanth Jayaraman, Tianhao Wang, Kang Bei, Karenah E Rajasekaran, Karthik Krishna, Hari Krishnan Krishnamurthy, Joseph A Murray
BACKGROUND AND AIMS: Celiac disease has characteristics of an autoimmune disease, such as increased antibody levels to tissue transglutaminase (tTG). However, assays to measure these biomarkers in blood samples do not identify patients with sufficient accuracy for diagnosis or monitoring of celiac disease. We aimed to discover biomarkers of celiac disease derived from neoepitopes of deamidated gliadin peptides (DGP) and tTG fragments and to determine if immune reactivity against these epitopes can identify patients with celiac disease with mucosal healing...
October 17, 2018: Gastroenterology
Jonas F Ludvigsson, Benjamin Lebwohl, Qi Chen, Gabriella Bröms, Randi L Wolf, Peter H R Green, Louise Emilsson
BACKGROUND: Coeliac disease has been linked to anxiety and depression. However, their association with mucosal healing is unknown. AIM: To examine the relationship between anxiety, depression and mucosal healing in coeliac disease. METHODS: Between 1969 and 2008, we collected data on all small intestinal biopsies with villous atrophy from Sweden's 28 pathology departments. We restricted our cohort to individuals with data on follow-up biopsy (either persistent villous atrophy [n = 3317] or mucosal healing [n = 4331])...
November 2018: Alimentary Pharmacology & Therapeutics
Nirmal K Onteddu, Venkata Siva Krishna Kumar Pulivarthi, Mihira Ginnavaram, Ramalinga Kedika
Olmesartan-induced enteropathy (OIE) typically presents with a constellation of signs and symptoms including chronic diarrhoea, weight loss and villous atrophy on biopsy. We describe a 68-year-old Caucasian woman with a history of hypothyroidism and hypertension who presented to our hospital with recurrent episodes of acute intermittent diarrhoea, nausea, vomiting, renal failure and 15 lbs weight loss. After an extensive workup, she was diagnosed with possible OIE. Cessation of the offending drug resulted in improvement of clinical symptoms and also hospital admissions for severe diarrhoea reinforcing the diagnosis of OIE...
October 2, 2018: BMJ Case Reports
Lori Connors, Andrew O'Keefe, Lana Rosenfield, Harold Kim
Non-immunoglobulin E (IgE)-mediated food hypersensitivity includes a spectrum of disorders that predominantly affect the gastrointestinal tract. This review will focus on the following more common non-IgE-mediated food hypersensitivity syndromes: food protein-induced enterocolitis syndrome (FPIES), allergic proctocolitis (AP), food protein-induced enteropathy (FPE) and celiac disease. FPIES, AP and FPE typically present in infancy and are most commonly triggered by cow's milk protein or soy. The usual presenting features are profuse emesis and dehydration in FPIES; blood-streaked and mucousy stools in AP; and protracted diarrhea with malabsorption in FPE...
2018: Allergy, Asthma, and Clinical Immunology
Coralie Derrieux, Amélie Trinquand, Julie Bruneau, Virginie Verkarre, Ludovic Lhermitte, Marion Alcantara, Patrick Villarese, Bertrand Meresse, David Sibon, Olivier Hermine, Nicole Brousse, Thierry Molina, Christophe Cellier, Nadine Cerf-Bensussan, Georgia Malamut, Elizabeth Macintyre
Celiac disease is a chronic inflammation of the small intestine with villous atrophy that can become refractory to a gluten-free diet. Two categories of refractory celiac disease can be distinguished by the phenotype of intraepithelial lymphocytes and the status of TRG genes. Their distinction is important because 30% to 50% of type II but only 0% to 14% of type I evolve to an aggressive enteropathy-associated T-cell lymphoma and therefore require intensive treatment. Currently, differential diagnosis integrates immunohistochemistry, immunophenotyping, and TRG clonality analyses, but each has limitations...
September 28, 2018: Journal of Molecular Diagnostics: JMD
Kazuya Higashizono, Kazuhiko Fukatsu, Ayako Watkins, Tomoki Watanabe, Midori Noguchi, Motonari Ri, Satoshi Murakoshi, Hiroshi Yasuhara, Yasuyuki Seto
BACKGROUND: Preoperative carbohydrate (CHO) supplementation has been recommended in enhanced recovery after surgery protocols. However, the effects of CHO supplementation on gut and systemic immunity are not well understood. METHODS: Mice (n = 60) were randomized to 1 of the following 5 groups: control (ad lib feeding), 12-hour fasting without CHO administration (fasting), and 12 hours of fasting with CHO administration at 2, 4, and 8 hours before sacrifice. Then, lymphocytes were isolated from gut-associated lymphoid tissue, that is, Peyer's patches, the intraepithelial space, and the lamina propria of the small intestine...
September 27, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
M C Rolfes, P Sriaroon, B J Dávila Saldaña, C C Dvorak, H Chapdelaine, R M Ferdman, K Chen, S Jolles, N C Patel, Y J Kim, T K Tarrant, T Martelius, M Seppanen, A Y Joshi
OBJECTIVE: Predictive factors associated with clinical outcomes of chronic norovirus infection (CNI) in primary immunodeficiency diseases (PIDD) are lacking. METHOD: We sought to characterize CNI using a multi-institutional cohort of patients with PIDD and CNI using the Clinical Immunology Society's CIS-PIDD Listserv e-mail group. RESULTS: Thirty-four subjects (21 males and 13 females) were reported from centers across North America, Europe, and Asia...
August 12, 2018: Diagnostic Microbiology and Infectious Disease
A Sadki, M Le Besnerais, F Héron, I Marie
INTRODUCTION: Olmesartan is an angiotensin II receptor blocker, used to treat arterial hypertension. Severe digestive manifestations have been associated with olmesartan, including sprue-like enteropathy and lymphocytic colitis. OBSERVATIONS: We report two cases of sprue-like enteropathy associated with olmesartan, leading to malabsorption syndrome related to villous atrophy. After olmesartan discontinuation, patients exhibited resolution of clinical digestive symptoms and disappearance of biochemical abnormalities...
August 30, 2018: La Revue de Médecine Interne
Jeremy R Glissen Brown, Prashant Singh
Coeliac disease (CD) develops in genetically susceptible individuals who, in response to unclear environmental triggers, develop an immune response triggered by gluten ingestion. It is now recognised as a global disease affecting about 0.7% of the world's population. The clinical presentation ranges from malabsorption to asymptomatic individuals diagnosed by screening high-risk groups. Diagnosis requires the demonstration of small intestinal villous atrophy in the presence of circulating coeliac auto-antibodies and/or an unequivocal response to a gluten-free diet (GFD)...
August 13, 2018: Paediatrics and International Child Health
Amanda K Cartee, Juan P Reyes Genere, Amy S Oxentenko
No abstract text is available yet for this article.
October 2018: Gastroenterology
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