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Celiac sprue

Robert C Oh, Thomas R Hustead, Syed M Ali, Matthew W Pantsari
Mild, asymptomatic elevations (less than five times the upper limit of normal) of alanine transaminase and aspartate transaminase levels are common in primary care. It is estimated that approximately 10% of the U.S. population has elevated transaminase levels. An approach based on the prevalence of diseases that cause asymptomatic transaminase elevations can help clinicians efficiently identify common and serious liver disease. The most common causes of elevated transaminase levels are nonalcoholic fatty liver disease and alcoholic liver disease...
December 1, 2017: American Family Physician
J Lasa, A Rausch, I Zubiaurre
INTRODUCTION AND AIMS: Whether celiac disease increases the risk of presenting with colorectal adenoma or not, has not been extensively evaluated. This question becomes relevant when considering early screening methods in patients with the disease. The aim of our article was to determine the risk of colorectal adenomas in celiac disease patients. MATERIALS AND METHODS: A computer-assisted search of the MEDLINE-Pubmed, EMBASE, LILACS, Cochrane Library, and Google Scholar databases was carried out, encompassing the time frame of 1966 to December 2016...
February 5, 2018: Revista de Gastroenterología de México
Aurelio Negro, Loredana De Marco, Valentina Cesario, Rosaria Santi, Maria Chiara Boni, Magda Zanelli
Sprue-like enteropathy associated with olmesartan medoxomil use has been recently reported. Its clinical manifestations include diarrhea, weight loss and malabsorption. Duodenal biopsies show villous atrophy (VA) with or without intraepithelial lymphocytosis and inflammation of the lamina propria. Serology for celiac disease (CD) is negative and gluten-free diet does not result in clinical improvement. Symptoms resolve after olmesartan discontinuation. Follow-up biopsies show recovery/improvement of the duodenum...
December 2017: Journal of Clinical Medicine Research
Thomas C Smyrk
Celiac disease features duodenal intraepithelial lymphocytosis with or without villous atrophy. Lymphocytosis without villous atrophy will be proven to represent celiac disease in 10% to 20% of cases. The differential diagnosis is broad: Helicobacter pylori gastritis, NSAID injury and bacterial overgrowth are considerations. Lymphocytosis with villous atrophy is very likely to be celiac disease, but there are mimics to consider, including collagenous sprue, tropical sprue, drug injury, and common variable immunodeficiency...
December 2017: Surgical Pathology Clinics
Catarina Atalaia-Martins, Sandra Barbeiro, Pedro Marcos, Isabel Cotrim, Helena Vasconcelos
Common variable immunodeficiency (CVID) is an immunodeficiency disorder with a high incidence of gastrointestinal (GI) manifestations and an increased risk of gastric malignancy. We report a case of a CVID with mild anemia presenting with multiple GI manifestations: gastric low-grade dysplasia (LGD), enteropathy with villous atrophy, refractory Giardia infection, nodular lymphoid hyperplasia, and inflammatory bowel-like disease. The differential diagnosis with celiac sprue could be challenging because of CVID enteropathy with villous flattening...
2017: ACG Case Reports Journal
J L Modesto Dos Santos, P González Recio, O A Terry López, I Leturia Frade, B Aguiar Losada, J I Elejalde Guerra
Olmesartan is an angiotensin II type 1 receptor blocker commonly used in the treatment of hypertension. Several cases of sprue-like enteropathy associated with the use of this drug have been described which, even with important signs and limitations for the patient, present a full recovery after discontinuing the use of olmesartan. The case of a 64 year-old patient is presented, diagnosed with hypertension, under treatment with olmesartan-amlodipine, with chronic diarrhoea and villous atrophy on intestinal biopsies without diagnostic criteria for celiac disease and with complete remission after suspending discontinuing the use of olmesartan...
July 4, 2017: Anales del Sistema Sanitario de Navarra
Uday C Ghoshal
A decade after Rome III, in 2016, Rome IV criteria were published. There are major differences between Rome IV and the earlier iteration, some of which are in line with Asian viewpoints. The clinical applicability of the Rome IV criteria of irritable bowel syndrome (IBS) in Asian perspective is reviewed here. Instead of considering functional gastrointestinal disorders (FGIDs) to be largely psychogenic, Rome IV suggested the importance of the gut over brain ("disorders of gut-brain interaction" not "brain-gut interaction")...
July 30, 2017: Journal of Neurogastroenterology and Motility
Ilaria Parzanese, Dorina Qehajaj, Federica Patrinicola, Merica Aralica, Maurizio Chiriva-Internati, Sanja Stifter, Luca Elli, Fabio Grizzi
Celiac disease, also known as "celiac sprue", is a chronic inflammatory disorder of the small intestine, produced by the ingestion of dietary gluten products in susceptible people. It is a multifactorial disease, including genetic and environmental factors. Environmental trigger is represented by gluten while the genetic predisposition has been identified in the major histocompatibility complex region. Celiac disease is not a rare disorder like previously thought, with a global prevalence around 1%. The reason of its under-recognition is mainly referable to the fact that about half of affected people do not have the classic gastrointestinal symptoms, but they present nonspecific manifestations of nutritional deficiency or have no symptoms at all...
May 15, 2017: World Journal of Gastrointestinal Pathophysiology
Jianzhuang Yao, Haixia Luo, Xia Wang
Celiac sprue, also known as gluten-sensitive enteropathy, is a chronic disease suffered by approximately 1% of the world's population. Engineered enzymes have been emerging to treat celiac disease by hydrolyzing the pathogenic peptides of gluten. For example, Kuma010 has been studied experimentally and proved to be a promising gluten hydrolase under gastric conditions. However, the detailed catalytic mechanism and the substrate specificity are still unclear. In this paper, quantum-mechanical/molecular-mechanical (QM/MM) molecular dynamics (MD) and free energy simulations were performed to determine the catalytic mechanism, the substrate specificity, and the role of the active-site residues during the reaction...
May 9, 2017: Journal of Chemical Information and Modeling
Abimbola Adike, Juan Corral, David Rybnicek, Daniel Sussman, Samir Shah, Eamonn Quigley
Olmesartan-induced enteropathy mimics celiac disease clinically and pathologically. As in celiac disease, the pathologic findings are villous atrophy and increased intraepithelial lymphocytes. Clinical presentation of olmesartan-induced enteropathy includes diarrhea, weight loss, and nausea. In contrast to celiac disease, tissue transglutaminase is not elevated and there is no response to a gluten-free diet. Including this entity in the differential diagnosis of sprue-like enteropathy is critical for its early diagnosis since replacing olmesartan with an alternative antihypertensive drug can simplify the diagnostic workup and provide both clinical and histologic improvement...
October 2016: Methodist DeBakey Cardiovascular Journal
Shannon P Sheedy, John M Barlow, Joel G Fletcher, Thomas C Smyrk, Francis J Scholz, Don C Codipilly, Badr F Al Bawardy, Jeff L Fidler
Celiac disease is an autoimmune disorder that causes inflammation and destruction in the small intestine of genetically susceptible individuals following ingestion of gluten. Awareness of the disease has increased; however, it remains a challenge to diagnose. This review summarizes the intestinal and extraintestinal cross-sectional imaging findings of celiac disease. Small intestine fold abnormalities are the most specific imaging findings for celiac disease, whereas most other imaging findings reflect a more generalized pattern seen with malabsorptive processes...
February 2017: Abdominal Radiology
Cláudio Martins, Cristina Teixeira, Suzane Ribeiro, Daniel Trabulo, Cláudia Cardoso, João Mangualde, Ricardo Freire, Ana Luísa Alves, Élia Gamito, Isabelle Cremers, Ana Paula Oliveira
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...
2016: Case Reports in Gastrointestinal Medicine
Bhanu Prakash Kolla, Meghna P Mansukhani, Steven I Altchuler
No abstract text is available yet for this article.
December 15, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Prasenjit Das, Ramakant Rawat, Anil K Verma, Geetika Singh, Archana G Vallonthaiel, Rajni Yadav, Gaurav P S Gahlot, Amit K Dinda, Vineet Ahuja, Siddhartha Datta Gupta, Sanjay K Agarwal, Govind K Makharia
Tissue transglutaminase 2 enzyme plays a diverse role in intracellular and extracellular functioning. Aberrant expression of anti-TG2 antibody has recently been proposed for extraintestinal identification of celiac disease (CeD), but its utility is questionable. To examine whether anti-TG2 immunohistochemical (IHC) staining can be of diagnostic value in identifying extraintestinal involvement in CeD, tissue blocks of patients with IgA nephropathies (IgAN), minimal change disease, membranous glomerulonephritis, membrano-proliferative glomerulonephritis, normal kidney, intestinal biopsies from CeD, tropical sprue, nonspecific duodenitis, and inflammatory bowel disease; liver biopsies from patients with chronic hepatitis B and C, acute liver failure (ALF), and CeD-associated liver diseases were retrieved and subjected to IHC staining for anti-tissue transglutaminase 2 enzyme...
October 7, 2016: Applied Immunohistochemistry & Molecular Morphology: AIMM
A I Parfenov, L M Krums
The paper presents a variety of clinical manifestations of malabsorption syndrome (MAS) in celiac disease, collagenous sprue, Whipple's disease, Crohn's disease, intestinal lymphangiectasia, amyloidosis, common variable immune deficiency, and treatment of short bowel syndrome. It shows the specific features of the pathophysiology, diagnosis, and treatment of MAS in small bowel diseases.
2016: Terapevticheskiĭ Arkhiv
Nan Lan, Bo Shen, Lisi Yuan, Xiuli Liu
BACKGROUND: Collagenous sprue (CS) is a rare form of enteropathy that had been reported to be associated with celiac disease (CD) and collagenous colitis (CC). The aim of our study was to compare the clinical features, treatments, and outcomes of CS, CD, and CC. METHODS: All patients with histologic diagnosis of CS, CD, or CC with complete clinical data were extracted from our pathology database between 1990 and 2015. Demographic and clinical features were recorded along with treatments and outcomes...
January 2017: Journal of Gastroenterology and Hepatology
Maria Cappello, Gaetano C Morreale, Anna Licata
Celiac sprue is a chronic disease, which usually occurs in children and young adults. However, it can develop in any age group, and the prevalence is increasing even in the elderly population. The atypical patterns of clinical presentation in this age group sometimes can cause a delay in diagnosis. Given the lower sensitivity and specificity of serological tests in the aged population, clinical suspect often arises in the presence of complications (autoimmune disorders, fractures, and finally, malignancy) and must be supported by endoscopic and imaging tools...
2016: Clinical Medicine Insights. Gastroenterology
Tasha Kulai, Thomas Arnason, Donald MacIntosh, John Igoe
Olmesartan, an angiotensin II receptor antagonist used to treat hypertension, is associated with few adverse effects. Here, a case of severe sprue-like enteropathy and acute kidney injury is described in a 68-year-old male taking olmesartan for 3-4 years. He presented to hospital with a five-week history of diarrhea, vomiting, and a 20 lb weight loss. Anti-TTG was negative with a normal IgA. Biopsies of the distal duodenum and duodenal cap revealed marked blunting of the villi with near complete villous atrophy of the biopsies from the bulb...
2016: Canadian Journal of Gastroenterology & Hepatology
Rashmi Patnayak, Vaikkakara Suresh, Amitabh Jena, Kadiyala Madhu, Bobbit Venkatesh Phaneendra, Venkatrami Reddy
Malabsorption syndrome (MAS) is a common condition in India. In Indian adults, tropical sprue and celiac disease are leading causes of MAS. Sometimes, the diagnosis of MAS may pose a challenge due to the varied signs and symptoms. We present a case of MAS in a young female, whose presenting symptoms were mainly neurological. She was successfully treated under regular follow-up for the past 6 years without any symptoms.
January 2016: Journal of Pediatric Neurosciences
Esteban Sáez González, Francia Carolina Díaz Jaime, Adolfo Del Val Antoñana
Olmesartan is one of the various angiotensin II antagonists currently used for the management of high blood pressure. A sprue-like enteropathy was first described in 2012 in association with this antihypertensive drug. An observational, descriptive study was carried out on a series of 12 patients who met the clinical, histopathological, and outcome criteria for olmesartan-related sprue-like enteropathy from May 2013 to December 2015. All patients had watery diarrhea, weight loss, and negative celiac serology...
October 2016: Revista Española de Enfermedades Digestivas
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