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    Most Children with Celiac Disease Have Atypical Symptoms


    Jefferson Adams

    Celiac.com 03/18/2010 - An international research team recently conducted an assessment of the nutritional status of children with newly diagnosed celiac disease, and compared the results to a group of matched control subjects.

    The team included B. Aurangzeb, S.T. Leach, D. A. Lemberg, and A. S. Day. They are associated variously with the Children's Hospital, Pakistan Institute of Medical Sciences in Islamabad, Pakistan, the Department of Paediatrics at the University of Otago in Christchurch, New Zealand, the School of Women's and Children's Health at the University of New South Wales, and the Department of Gastroenterology at Sydney Children's Hospital in Randwick, both in Sydney, Australia.

    In addition to gaining a better understanding of nutritional status in children with newly diagnosed celiac disease, the team sought to clarify the relationship between and nutrition and patterns of presentation in children with celiac disease.

    The team assessed nutritional status for newly diagnosed celiac disease patients using
    anthropometry, Bioelectrical Impedance and serum leptin levels, which they compared against age and gender matched control subjects.

    For the study, the team enrolled twenty-five children with clinically proven celiac disease, averaging 8.2 years old (± 4.5 years), along with 25 healthy control subjects averaging 8.1 years old (± 4.4 years).  A total of thirteen children with celiac disease experienced gastrointestinal symptoms, and fourteen had a family history of celiac disease. At presentation 8.7% showed physical wasting, 4.2% showed stunted growth, and 20.8% were overweight, though none were obese. There was no difference between the groups with regard to average height and weight for age, other nutritional parameters and serum leptin; which correlated with BMI in both groups.

    From these results, the team concluded that children with celiac disease more commonly present with atypical symptoms than with classical features. Children with celiac disease may present with nutritional deficiencies and/or excesses at diagnosis, completely independent of obvious symptoms. Celiac disease did not change leptin levels.

    The findings reiterate the importance of conducting nutritional assessments in the diagnosis and treatment of children with celiac disease.

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  • About Me

    Jefferson Adams earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, and science. He previously served as Health News Examiner for Examiner.com, and provided health and medical content for Sharecare.com.

    Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book Dangerous Grains by James Braly, MD and Ron Hoggan, MA.

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    Scott Adams
    Celiac.com 09/29/2003 - The results of a study published in the September edition of American Journal of Gastroenterology indicate that women with treated celiac disease suffer twice as many gastrointestinal symptoms than do their male counterparts, and that men with treated celiac disease suffered no more GI symptoms than did the normal population. More studies need to be done, however, to determine why male celiacs seem to respond better to treatment than females. Some follow-up work has already been done on this topic. -Scott
    Here is the abstract:


    Am J Gastroenterol. 2003 Sep;98(9):2023-6.
    High rate of gastrointestinal symptoms in celiac patients living on a gluten-free diet: controlled study.
    Midhagen G, Hallert C.
    Department of Internal Medicine, Skovde Hospital, Skovde, Sweden
    The aim of this study was to determine the occurrence of GI symptoms in adults with celiac disease (celiac disease) treated with a gluten-free diet for several years. We studied a cohort of adults with celiac disease (n = 51; 59% women) aged 45-64 yr and proved to be in remission after 8-12 yr of treatment. They were examined by the GI Symptom Rating Scale, which comprises five syndromes: indigestion, diarrhea, constipation, abdominal pain, and reflux. A general population sample (n = 182; 57% women) of same age served as controls. Subjects with celiac disease reported significantly more GI symptoms than the general population sample, as assessed by the GI Symptom Rating Scale total score (p

    Jefferson Adams
    Celiac.com 04/23/2007 - A recent study published in the American Journal of Gastroenterology suggests that individuals afflicted with celiac disease in childhood suffer long-term mortality rates that are three times higher than those of the general population
    The study set out to determine the most common celiac symptoms faced by clinicians, and to determine how effective an active case-finding strategy might be in raising the levels of diagnosis.
    Researchers led by Dr. Masoud Solaymani-Dodaran of Queens Medical Centre, Nottingham, UK, compared differences in long-term mortality in celiac patients diagnosed as children or adults against long-term mortality rates for the general population.
    The results showed that standardized mortality ratios for celiac patients more than 5 years after childhood diagnosis were 3.32, while ratios for those diagnosed as adults were 1.38.
    Deaths from accidents, suicide, and violence, malignancies, and cerebrovascular diseases largely accounted for the elevated mortality risk among celiacs diagnosed as children. For those diagnosed as adults, excess mortality rates were largely due to malignant neoplasms.
    Researchers said that nature of, and the increase in, mortality rates suffered by children with celiac was both largely unexpected, and surprising, when compared to those of adults.
    Noting that celiacs diagnosed as adults faced only a "reassuringly small increase" in long-term mortality rates; rates that are approximately half of those of patients with Crohn's disease, for example.
    They contrasted the adult rates to the markedly higher mortality rates faced by celiacs diagnosed as children, which, they said was "difficult to attribute directly to the disease itself."
    They concluded that even though the increased risk of mortality for faced by celiacs diagnosed as children was small overall, the excess of deaths from accidents, suicides, and violence, were, nonetheless, a "cause for concern."
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    Jefferson Adams
    High Levels of Oxidative DNA Damage in Children with Celiac Disease
    Celiac.com 09/20/2010 - People with celiac disease face increased risk of cancer and a large amount of circumstantial evidence suggests that oxidatively damaged DNA may be used to help predict future cancer development in celiac patients.
    To evaluate that hypothesis, a research team set out to assess and describe oxidative stress and oxidative DNA damage in celiac disease patients.
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    They found that children with celiac disease have higher than normal levels of the oxidative DNA damage biomarkers urinary 8-oxodG and 8-oxoGua, regardless of following a gluten-free diet.
    To measure urinary excretion of 8-oxodG and 8-oxoGua, and levels of oxidative DNA damage in the leukocytes, as well as the level of antioxidant vitamins, the team used high-performance liquid chromatography (HPLC) and HPLC/gas chromatography with isotope dilution mass detection.
    They observed parameters for DNA damage in a group of children with untreated celiac disease, in a group of children with celiac disease following a strict gluten-free diet, and in a control group of healthy children.
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    Jefferson Adams
    Celiac.com 06/13/2012 - In general, doctors and researchers know a good deal about how celiac disease works, and they are finding out more all the time. However, they know very little about non-celiac gluten sensitivity (NCGS).
    In an effort to learn more about non-celiac gluten sensitivity, a team of researchers recently carried out a study to measure the presence of somatization, personality traits, anxiety, depression, and health-related quality of life in NCGS individuals, and to compare the results with celiac disease patients and healthy control subjects. They also compared the response to gluten challenge between patients with non-celiac gluten sensitivity and those with celiac disease.
    The research team included M. Brottveit, P.O. Vandvik, S. Wojniusz, A. Løvik, K.E. Lundin, and B. Boye, of the Department of Gastroenterology at Oslo University Hospital, Ullevål in Oslo, Norway.
    In all, the team looked at 22 patients with celiac disease and 31 HLA-DQ2+ NCGS patients without celiac disease. All patients were following a gluten-free diet.
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    Source:
    Scand J Gastroenterol. 2012 Apr 23.

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