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    No Higher Cancer Risk for Silent Celiac Disease


    Jefferson Adams

    Celiac.com 05/13/2009 - People with silent celiac disease, those who test positive for celiac disease antibodies, yet show no clinical signs of the disease itself, do not face a higher risk for developing malignant cancers, according to results of a recent Finnish study.


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    Previous studies done in the 1970s and 1980s indicated that patients with clinically recognized celiac disease face a higher risk for developing malignancies, Dr. Katri Kaukinen, of the University of Tampere, Finland, told reporters from Reuters Health. However, she explained, "it has not been known whether apparently clinically silent unrecognized cases also carry an increased risk of celiac disease-related complications, and thus whether the healthcare system should recognize and treat."

    In an effort to answer that question, Dr. Kaukinen led team of researchers in assessing whether adults with previously unrecognized screening-identified evidence of celiac disease have an increased risk of malignancies.

    Recent screening figures put the prevalence of celiac disease somewhere between 1% and 2% of the population, which means from 7 to 14 million Europeans with gluten intolerance. 75% to 90% of all the celiac disease remains undiagnosed due to absent or atypical symptoms.

    The team examined data from a Finnish population-based adult-representative cohort of 8000 subjects compiled from 1978 to 1980. In 2001, the researchers screened blood samples of people with no history of celiac disease or any malignancy (n = 6849) for immunoglobulin A (IgA) class tissue transglutaminase antibodies. They further screened
    positive samples for IgA class tissue transglutaminase antibodies (Celikey tTG) and for IgA endomysial antibodies (EMA).

    The team analyzed a total of 6849 blood samples. 565 samples showed positive Eu-tTG results. 202 of these subjects showed positive Celikey tTG results ((2.9%) while 73 showed positive EMA screens (1.1%).

    Just over 10% of the study subjects, a total of 694 participants, developed malignancies during the period of the study. Overall malignancy risk was no higher for celiac autoantibody-positive subjects. Adjusted for age and sex, the results showed that the relative risks were 0.91 for those who were Celikey tTG positive, and 0.67 and for those who were EMA positive.

    According to Dr. Kaukinen, the results seem to support the current clinical approach, and suggests that "earlier diagnosis of the disease through serological mass screening would not be beneficial in improving the prognosis of celiac disease as regards malignancies."

    However, before completely ruling out mass screening, Dr Kaukinen noted that it is important to pursue "further prognostic studies [on] mortality and fractures among earlier unrecognized celiac disease cases," as "[t]hese issues should be also addressed" before any official decisions are made regarding the use of mass blood screening for celiac disease.


    Gut 2009; 58:643-647.

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    Guest Andrés

    Posted

    So is there a higher risk of cancer if we don't follow the gluten-free diet or not? I wouldn't mind getting the occasional diarrhea abdominal pains if I could lead a normal life again.

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    Guest Nancy

    Posted

    My celiac was found by my doctor investigating liver disease. I didn't have IBS until I started the gluten-free diet 6 months ago. If there's no risk of cancer, why am I on this horrible diet? My favorite foods are pasta and bread and I don't like the substitutes made with corn.

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    "No higher risk for silent disease" is not through any more! There was a new research about risk of mortality for silent disease and silent disease got the highest risk.

    Gluten sensitivity raises death risk (75% more), it is half for celiac (33% more); it is once again the proof that gluten is toxic and we just start to understand how much with research like this one. In France, I fight to obtain less gluten for everyone in food from agro-business but there is even more gluten in American food and I don't know if American celiacs act to make this danger well known by every consumer?

    Friendly yours!

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  • Related Articles

    Scott Adams
    Am J Med. 2003 Aug 15;115(3):191-5
    Celiac.com 09/03/2003 - The results of a study conducted by Dr. Peter Green and colleagues at the College of Physicians and Surgeons in New York City indicate that, despite a gluten-free diet, people with celiac disease still have an elevated risk of getting non-Hodgkins lymphoma. The good news is that the risk of getting other types of cancers like small intestinal adenocarcinoma, esophageal cancer and melanoma were reduced in patients who adhered to a gluten-free diet, as was the overall risk of getting non-Hodgkins lymphoma. The study looked at 381 celiac disease patients, out of which 43 were diagnosed with cancer (11%). The vast majority—34—were diagnosed at or before their celiac disease diagnoses, so it is safe to say that they were not following a gluten-free diet.
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    Departments of Medicine (PHRG, RG, AIN), College of Physicians and Surgeons, New York, New York, USA
    Studies from Europe have demonstrated an increased risk of malignancy, especially non-Hodgkins lymphoma, in patients with celiac disease. However, there are no data on the risk for similar patients in the United States. Our aim was to estimate the risk of malignancy in a cohort of patients with celiac disease compared with the general U.S. population and to determine if a gluten-free diet is protective. Patients with celiac disease seen between July 1981 and January 2000 at a referral center were included. Standardized morbidity ratios (SMRs) (ratio of observed to expected) and corresponding 95% confidence intervals (CI) were calculated, using data from the National Cancer Institutes Surveillance, Epidemiology, and End Results Program. Forty-three (11%) of 381 celiac disease patients had a diagnosis of cancer; 9 were after the diagnosis of celiac disease, 7 were simultaneous (during same month of admission), and 27 were before the diagnosis. The standardized morbidity ratio for all cancers combined was 1.5 (95% CI: 0.3 to 7.5), with significantly increased values for small bowel cancer (SMR = 34; 95% CI: 24 to 42), esophageal cancer (SMR = 12; 95% CI: 6.5 to 21), non-Hodgkins lymphoma (SMR = 9.1; 95% CI: 4.7 to 13), and melanoma (SMR = 5.0; 95% CI: 2.1 to 12). Following the diagnosis of celiac disease, patients were at increased risk of non-Hodgkins lymphoma only (SMR = 6.2; 95% CI: 2.9 to 14), despite adherence to a gluten-free diet. The non-Hodgkins lymphoma included both T-cell and B-cell types and occurred in both gastrointestinal (n = 5) and extra intestinal sites (n = 4). In this cohort of patients with celiac disease, we observed increased risks of small intestinal adenocarcinoma, esophageal cancer, melanoma, and non-Hodgkins lymphoma. The risk of non-Hodgkins lymphoma persisted despite a gluten-free diet.

    Jefferson Adams
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    Alimentary Pharmacology & Therapeutics 2010;32(8):1037-1043.

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  • Recent Articles

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    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

    Jefferson Adams
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    Source:
    Journal of Clinical Pathologyhttp://dx.doi.org/10.1136/jclinpath-2018-205023

    Jefferson Adams
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    Source:
    Alimentary Pharmacology & Therapeutics

    Jefferson Adams
    Celiac.com 06/12/2018 - A life-long gluten-free diet is the only proven treatment for celiac disease. However, current methods for assessing gluten-free diet compliance are lack the sensitivity to detect occasional dietary transgressions that may cause gut mucosal damage. So, basically, there’s currently no good way to tell if celiac patients are suffering gut damage from low-level gluten contamination.
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    Source:
    Gut. 2017 Feb;66(2):250-257.  doi: 10.1136/gutjnl-2015-310148.