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https://www.readbyqxmd.com/read/28725310/refractory-celiac-disease-successfully-treated-with-azathioprine
#1
Umair Iqbal, Ahmad Chaudhary, Muhammad Arsalan Karim, Hafsa Anwar, Nancy Merrell
Refractory celiac disease (CD) is a clinical diagnosis defined by the persistence of signs/symptoms, laboratory abnormalities or villous atrophy typical of CD despite strict adherence to a gluten-free diet for at least 6 - 12 months. It should be suspected when patients with CD fail to respond primarily or secondarily to a gluten-free diet, especially if there is significant weight loss. Differentiation between types is important both for management and predicting prognosis. Type I can be managed with mild immunosuppression with nutritional support...
June 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28724585/effect-of-gluten-free-diet-on-cerebellar-mr-spectroscopy-in-gluten-ataxia
#2
Marios Hadjivassiliou, Richard A Grünewald, David S Sanders, Priya Shanmugarajah, Nigel Hoggard
OBJECTIVE: To evaluate the effect of gluten free diet (GFD) on magnetic resonance spectroscopy (MRS) of the cerebellum in patients with gluten ataxia (GA). METHODS: Patients with GA, defined as sporadic ataxia with positive antigliadin antibodies in the absence of an alternative cause, routinely undergo MRS at baseline and after the introduction of GFD as part of their clinical care. We present our experience of the effect of GFD on MRS of the cerebellum. RESULTS: A total of 117 consecutive patients with GA were included in this report...
July 19, 2017: Neurology
https://www.readbyqxmd.com/read/28721692/left-ventricular-mechanics-are-affected-in-children-with-celiac-disease-a-study-based-on-two-dimensional-speckle-tracking-echocardiography
#3
Murat Deveci, Ayşen Uncuoğlu Aydoğan, Gürkan Altun, Özlem Kayabey, Okan Tuğral, Kadir Babaoğlu
BACKGROUND: An association between cardiomyopathy and celiac disease has been reported, but not frequently. We examined the effects on cardiac mechanics in children with celiac disease (CD) by two-dimensional speckle tracking echocardiography (2DSTE). METHODS: Eighty-one children with CD were compared with a control group comprising 51 healthy children by echocardiographic examination. Children with CD who had been on gluten-free diet for more than 6 months were divided into two different groups: group 1 was positive for serum antitissue transglutaminase antibody (n=48), and group 2 was negative for serum antitissue transglutaminase antibody (n=33)...
July 18, 2017: Echocardiography
https://www.readbyqxmd.com/read/28708086/celiac-disease-presenting-with-peripheral-neuropathy-in-children-a-case-report
#4
Alessandra Pacitto, Alessandra Paglino, Lorenza Di Genova, Alberto Leonardi, Edoardo Farinelli, Nicola Principi, Giuseppe di Cara, Susanna Esposito
Background: Clinically relevant neurological manifestations in children with celiac disease (CD) are unusual, especially when they are considered as signs of the onset of the disease. In this paper, a case of Guillain-Barrè syndrome (GBS) as the first manifestation of CD in a 23-month-old child is reported. Case presentation: We describe a case of CD onset with peripheral neuropathy in a 23-month-old Bulgarian boy presenting with a sudden refusal to walk and absence of deep tendon reflexes in both lower limbs...
July 14, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28704189/chronic-hepatitis-due-to-gluten-enteropathy-a-case-report
#5
Irina I Ivanova, Denitsa Y Dukova, Pavlina G Boikova, Lili S Grudeva, Ivan B Shalev, Iskren A Kotzev
BACKGROUND: Celiac disease is an immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed individuals. CASE DESCRIPTION: A 45-year-old Caucasian woman presented with severe iron-deficient anemia and mild elevation of liver enzymes. Upper endoscopy was done in the context of evaluation of anemia, which revealed reduced duodenal folds and mosaic pattern of the mucosa, but also grade II esophageal varices and portal hypertensive gastropathy...
June 1, 2017: Folia Medica
https://www.readbyqxmd.com/read/28702325/the-human-digestive-tract-has-proteases-capable-of-gluten-hydrolysis
#6
Sergio Gutiérrez, Jenifer Pérez-Andrés, Honorina Martínez-Blanco, Miguel Angel Ferrero, Luis Vaquero, Santiago Vivas, Javier Casqueiro, Leandro B Rodríguez-Aparicio
OBJECTIVE: To identify, purify, and characterize the proteins responsible for glutenase activity in the feces of healthy subjects and patients with celiac disease (CD). METHODS: Sixteen subjects were included in this study; 8 were healthy with no known food intolerances, and 8 were treated CD patients on a gluten-free diet. Fecal samples were homogenized, and precipitated proteins were purified by chromatography. Glutenase activity was evaluated by bioassays, zymography, and high-performance liquid chromatography with immunogenic 33-mer, 19-mer, and 13-mer gliadin peptides...
July 2017: Molecular Metabolism
https://www.readbyqxmd.com/read/28702130/new-insights-in-ibs-like-disorders-pandora-s-box-has-been-opened-a-review
#7
REVIEW
Raffaele Borghini, Giuseppe Donato, Domenico Alvaro, Antonio Picarelli
The most complained gastrointestinal symptoms are chronic diarrhea, bloating and abdominal pain. Once malignancies and inflammatory bowel diseases are excluded, irritable bowel syndrome (IBS) and the so called "IBS-like disorders" should be taken into account. The relationship between IBS as defined by Rome IV criteria and these clinical conditions is sometimes obscure, since many IBS patients identify food as a possible trigger for their symptoms. Here, we discuss IBS and the most common IBS-like disorders (celiac disease, non-celiac gluten sensitivity, fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs), lactose intolerance, small intestinal bacterial overgrowth (SIBO), α-amylase/trypsin inhibitor (ATIs), nickel allergic contact mucositis), focusing on epidemiologic, clinical, diagnostic and therapeutic aspects...
2017: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/28695870/deranged-regulatory-t-cells-and-transforming-growth-factor-%C3%AE-1-levels-in-type-1-diabetes-patients-with-associated-autoimmune-diseases
#8
N Kaur, R W Minz, S K Bhadada, D Dayal, J Singh, S Anand
AIM: This study was designed to enumerate regulatory T-cells (Tregs) and estimate transforming growth factor-β1 (TGF-β1) levels in type 1 diabetic (T1D) patients with respect to disease duration and associated autoimmune diseases. METHODS: One hundred and fifty patients and twenty healthy controls were recruited in the study. The patients were subcategorized into eight categories on the basis of disease duration (new onset [NO] and long standing [LS]) and associated diseases, i...
July 2017: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/28695483/diagnosis-and-management-of-treatment-refractory-hypothyroidism-an-expert-consensus-report
#9
REVIEW
M Centanni, S Benvenga, I Sachmechi
There is a frequently encountered subset of hypothyroid patients who are refractory to standard thyroid hormone replacement treatment and require unexpectedly high doses of levothyroxine. In addition to clinical situations where hypothyroid patients are non-compliant, or where there is the possibility of excipient-induced disease exacerbation (gluten/celiac disease), therapeutic failure may be due to impaired absorption of the administered drug. The common approach to managing patients with unusual thyroxine needs is to escalate the dose of levothyroxine until targeted TSH levels are achieved...
July 10, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28695286/the-roles-of-mhc-class-ii-genes-and-post-translational-modification-in-celiac-disease
#10
REVIEW
Ludvig M Sollid
Our increasing understanding of the etiology of celiac disease, previously considered a simple food hypersensitivity disorder caused by an immune response to cereal gluten proteins, challenges established concepts of autoimmunity. HLA is a chief genetic determinant, and certain HLA-DQ allotypes predispose to the disease by presenting posttranslationally modified (deamidated) gluten peptides to CD4(+) T cells. The deamidation of gluten peptides is mediated by transglutaminase 2. Strikingly, celiac disease patients generate highly disease-specific autoantibodies to the transglutaminase 2 enzyme...
July 10, 2017: Immunogenetics
https://www.readbyqxmd.com/read/28691413/diagnostic-challenges-in-celiac-disease
#11
REVIEW
Karol Kowalski, Agata Mulak, Maria Jasińska, Leszek Paradowski
Diagnosis of celiac disease in adults is currently based on serologic tests in combination with histopathological assessment of small intestinal biopsy specimens. High titers of celiac-specific antibodies in immunocompetent patients with villous atrophy in a good quality biopsy sample allow to state confident diagnosis. Relive of symptoms and histological improvement after embarking on a gluten free diet further support initial diagnosis. However, in some cases, these conditions are not fulfilled what requires critical evaluation of laboratory and histopathology results and consideration of other potential causes for observed pathologies...
June 27, 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28688105/intussusception-in-celiac-disease-is-it-a-common-feature-in-children
#12
Vibhor V Borkar, Ujjal Poddar, Anuj Thakral, Jaya Agarwal, Anshu Srivastava, Surender Kumar Yachha, Sheo Kumar
BACKGROUND/AIMS: There are sporadic reports of occurrence of intussusception in celiac disease (CD) but no systematic study yet. We prospectively studied the prevalence and natural history of intussusception in newly diagnosed CD. METHODS: From January 2010 to October 2013, 150 children, diagnosed to have CD on the basis of positive serology and duodenal biopsy, were recruited in this study. Abdominal ultrasonography was done before starting gluten-free diet (GFD) and repeated in those who had intussusception, on day three and then weekly till the resolution of intussusception...
July 7, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28687943/symptoms-of-functional-intestinal-disorders-are-common-in-patients-with-celiac-disease-following-transition-to-a-gluten-free-diet
#13
Jocelyn A Silvester, Lesley A Graff, Lisa Rigaux, Charles N Bernstein, Daniel A Leffler, Ciarán P Kelly, John R Walker, Donald R Duerksen
BACKGROUND: Celiac disease and functional intestinal disorders may overlap, yet the natural history of functional symptoms in patients with celiac disease is unknown. AIM: To investigate the prevalence of irritable bowel syndrome (IBS), functional dyspepsia (FD), and functional bloating (FB) symptoms among patients with celiac disease at diagnosis and during the first year of a gluten-free diet. METHODS: Adults with a new diagnosis of celiac disease were surveyed at baseline, 6 months and 1 year using standardized measures for intestinal symptoms [Rome III diagnostic questionnaire and celiac symptom index (CSI)] and gluten-free diet adherence [gluten-free eating assessment tool (GF-EAT) and celiac diet adherence test]...
July 7, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28686601/maternal-and-neonatal-vitamin-d-status-genotype-and-childhood-celiac-disease
#14
Karl Mårild, German Tapia, Margareta Haugen, Sandra R Dahl, Arieh S Cohen, Marika Lundqvist, Benedicte A Lie, Lars C Stene, Ketil Størdal
BACKGROUND: Low concentration of 25-hydroxyvitamin D during pregnancy may be associated with offspring autoimmune disorders. Little is known about environmental triggers except gluten for celiac disease, a common immune-mediated disorder where seasonality of birth has been reported as a risk factor. We therefore aimed to test whether low maternal and neonatal 25-hydroxyvitamin D predicted higher risk of childhood celiac disease. METHODS AND FINDINGS: In this Norwegian nationwide pregnancy cohort (n = 113,053) and nested case-control study, we analyzed 25-hydroxyvitamin D in maternal blood from mid-pregnancy, postpartum and cord plasma of 416 children who developed celiac disease and 570 randomly selected controls...
2017: PloS One
https://www.readbyqxmd.com/read/28677884/assessing-the-proposed-association-between-ded-and-gluten-free-diet-introduction-in-celiac-children
#15
Alexandra Mussolino de Queiroz, Juliana Arid, Fabrício Kitazono de Carvalho, Raquel Assed Bezerra da Silva, Erika Calvano Küchler, Regina Sawamura, Lea Assed Bezerra da Silva, Paulo Nelson-Filho
A strong association between celiac disease (CD) and dental enamel defects (DEDs) have been extensively reported, however, the nature of this relationship is still unclear. The aim of this study was to evaluate DEDs phenotype in CD individuals according to the time they were introduced to a gluten-free diet (GFD). Forty-five CD individuals were examined by a pediatric dentist. DEDs were classified according to the type of affected teeth. CD individuals were classified into two groups (with or without DEDs) and the differences between these groups were tested using chi-square or Fisher´s exact tests and t-test to compare differences between means...
July 2017: Special Care in Dentistry
https://www.readbyqxmd.com/read/28673580/the-enteric-toxicity-of-gluten-enhances-graft-versus-host-disease-after-allogeneic-hematopoietic-stem-cell-transplantation
#16
Taylor Neuman, Kevin David, Dennis Cooper, Roger Strair
Pro-inflammatory peptides present in wheat and related grains are associated with celiac disease and non-celiac gluten sensitivity. We hypothesize that these peptides induce enteric responses that may exacerbate the gastrointestinal manifestations of graft-versus-host disease after an allogeneic hematopoietic stem cell transplant. Therefore, we propose that a gluten free diet should be tested as a prophylactic and/or therapeutic intervention against gastrointestinal graft-versus-host disease for patients undergoing an allogeneic hematopoietic stem cell transplant...
July 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28662204/validation-of-an-algorithm-to-identify-children-with-biopsy-proven-celiac-disease-from-within-health-administrative-data-an-assessment-of-health-services-utilization-patterns-in-ontario-canada
#17
Jason Chan, David R Mack, Douglas G Manuel, Nassim Mojaverian, Joseph de Nanassy, Eric I Benchimol
IMPORTANCE: Celiac disease (CD) is a common pediatric illness, and awareness of gluten-related disorders including CD is growing. Health administrative data represents a unique opportunity to conduct population-based surveillance of this chronic condition and assess the impact of caring for children with CD on the health system. OBJECTIVE: The objective of the study was to validate an algorithm based on health administrative data diagnostic codes to accurately identify children with biopsy-proven CD...
2017: PloS One
https://www.readbyqxmd.com/read/28661426/rational-design-of-recombinant-papain-like-cysteine-protease-optimal-domain-structure-and-expression-conditions-for-wheat-derived-enzyme-triticain-%C3%AE
#18
Neonila V Gorokhovets, Vladimir A Makarov, Anastasiia I Petushkova, Olga S Prokopets, Mikhail A Rubtsov, Lyudmila V Savvateeva, Evgeni Yu Zernii, Andrey A Zamyatnin
Triticain-α is a papain-like cysteine protease from wheat (Triticumaestivum L.) that possesses activity towards toxic gluten-derived peptides, and was thus proposed as a novel therapeutic tool for celiac disease. We report an original approach employing rational design of domain architecture of Triticain-α and selection of the appropriate expression system for development of cheap and efficient protocol yielding active recombinant enzyme. The segregated catalytic domain of Triticain-α did not adopt native structure in bacteria, neither being expressed as a single protein nor upon conjugation or co-expression with extrinsic chaperones...
June 29, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28658068/depression-and-insomnia-among-individuals-with-celiac-disease-or-on-a-gluten-free-diet-in-the-usa-results-from-a-national-survey
#19
Haley M Zylberberg, Ryan T Demmer, Joseph A Murray, Peter H R Green, Benjamin Lebwohl
BACKGROUND: There is uncertainty regarding the prevalence of psychiatric illnesses in patients with celiac disease (CD) and people who avoid gluten (PWAG) without a diagnosis of CD. PARTICIPANTS AND METHODS: We obtained data from 22 274 participants from the 2009-2014 National Health and Nutrition Examination Survey to compare the prevalence of depression, insomnia, quality-of-life variables, and psychotropic medication use in CD participants and PWAGs to controls...
June 27, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28655974/lymphocytic-duodenitis-or-microscopic-enteritis-and-gluten-related-conditions-what-needs-to-be-explored
#20
REVIEW
Enzo Ierardi, Giuseppe Losurdo, Andrea Iannone, Domenico Piscitelli, Annacinzia Amoruso, Michele Barone, Mariabeatrice Principi, Antonio Pisani, Alfredo Di Leo
Microscopic enteritis (ME) is characterized by abnormal infiltration of intraepithelial lymphocytes in intestinal mucosa. It was described as duodenal lymphocytosis or lymphocytic duodenitis until the dedicated Consensus Conference of 2015. ME represents a common feature of several gluten-mediated and non-gluten related diseases; therefore, it is an umbrella term embracing several conditions. The most frequent causes of ME are gluten-related disorders (celiac disease, non-celiac gluten sensitivity, wheat allergy), Helicobacter pylori infection and drug-related damages...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
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