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    Scott Adams
    This recipe comes to us from Sue Foss.
    Preheat oven 375F.
    Ingredients:
    1 package ground turkey
    1 cup ricotta (part skim or whole ricotta works best)
    ½ - ¾ cup Basil Pesto
    1 Egg (beaten)
    1-2 cups of your favorite tomato pasta sauce (unused sauce to put on sliced meatloaf)
    Directions:
    Knead first 3 ingredients together and then mix in egg. Press into greased loaf pan. Spoon on several tablespoons of tomato sauce on top of meatloaf and bake uncovered for 1 hour 10 minutes.

    Scott Adams
    This recipe comes to us from Valerie Wells.
    2 pounds beef cut into 1 inch pieces (or stew meat)
    1 can S&W Ready Cut Tomatoes
    6 ounce can tomato sauce (Contadina)
    1 tablespoon fresh Rosemary leaves, minced
    1 tablespoon fresh oregano leaves, minced
    2 tablespoons chopped onion
    4 cloves garlic, minced
    Salt & fresh ground black pepper to taste
    ¼ cup tapioca pearls (sometimes called instant tapioca look in pudding section of store)
    Load everything into crock pot & cook for 8 to 10 hours on low. Serve over pasta, rice, potatoes or spaghetti squash.

    Scott Adams
    This recipe comes to us from Valda - ArtGirl in the Gluten-Free Forum.
    Ingredients:
    1 can of Amys Lentil-Vegetable Soup
    1 pound (or more) ground meat - half hamburger, half lamb
    Salt
    Dried basil
    One cup chopped carrots (about 3-4 carrots)
    One cup of potatoes, peeled and cut in small pieces (about 2 med-sized potatoes)
    Directions - Patties:
    Mix together ground lamb and ground beef (50/50)
    Into this mixture add some salt and dried basil (approx 1/8 tsp or to taste)
    Shape into small patties (I like to make my flat ovals, about 2 long)
    Fry patties until done. Drain on papertowels.
    Directions - Vegetables:
    Cook the carrots a saucepan with water. Drain.
    Cook the potatoes in another saucepan with water. Drain
    Directions - After the meat and vegetables are cooked:
    Pour the Amys lentil vegetable soup in a 10-12 frying pan.
    Stir in the carrots.
    Place the cooked meat patties in a ring around the outer edge of the pan, settling them into the soup.
    Make a well in the center of the mixture and place the cooked potatoes together in the center, stir slightly to coat the potatoes with the broth.
    Heat covered on low until all is hot.
    Serve in the pan.
    Serves 3-4. Increase meat and potatoes if you need more servings.

    Scott Adams
    This recipe comes to us from Kathy Bennett.
    Ingredients:
    ½ pound softened butter
    8 ounce softened cream cheese
    2 tablespoons vanilla extract
    5 tablespoons sweetened condensed milk
    3.5 ounce can Baker’s coconut
    2 pounds 10x sugar
    Cinnamon
    Directions (By Hand):
    Mix butter and cream cheese
    Gradually add in vanilla - mix well
    Gradually add in condensed milk - mix well
    Gradually add in sifted 10x sugar - mix well
    Mix in the coconut
    Scoop out by teaspoonfuls and plop on a cookie sheet
    Cover with waxed paper and
    Chill in the refrigerator for 15 minutes
    Roll into balls
    Roll in cinnamon
    Store in the refrigerator

    Scott Adams
    Soaking chicken in salt water, or brining and frying it in lard, are the keys to great fried chicken. However, you may choose to substitute 2 cups vegetable oil for the lard.
    Ingredients:
    ¼ cup plus 1 teaspoon salt, divided
    6 cups water
    3 pound chicken, cut into 8 pieces, or 3 pounds of thighs or drumsticks 1 quart gluten-free buttermilk
    1 pound lard or 2 cups vegetable oil
    ½ cup unsalted butter
    1-2 cups gluten-free flour blend* (can include some soy flour for crunchy, texture and golden color)
    2 Tablespoon cornstarch
    ½ teaspoon coarsely ground black pepper
    Bacon or ham chunks
    Directions:
    Combine ¼ cup salt and water in a heavy-duty zip-top plastic bag. Add chicken; seal bag and marinate in refrigerator for 8 hours. Drain. Combine chicken and buttermilk in a large bowl. Cover and refrigerate 8-12 hours. Drain on a wire rack. Combine lard or oil, plus butter in a heavy skillet. Begin by sautéing the pork in the oil. This adds tremendous flavor to the chicken.
    Combine flour, cornstarch, 1 teaspoon salt and pepper on a piece of wax paper. Dredge chicken in flour mixture; tap well to remove excess. Working in batches, place chicken, skin side down, into heated oil. Do not crowd. Cook until chicken is golden brown and cooked, 10-12 minutes per side.
    Pierce with a fork; if juices run clear, chicken is done. Remove and drain thoroughly on a wire rack.
    Makes: 6 servings.
     


    Jefferson Adams
    When I was growing up, pot roast was one of the most favorite things my mom made. I fondly remember many a Sunday when I came home to the smell of pot roast cooking in the oven, and counted the minutes until dinner hit the table.
    These days, with time being tight, I rarely get a chance to make pot roast. This recipe uses a slow cooker to make a delicious, moist and juicy pot roast with carrots, onion and potatoes. Even better, it is easy to prepare, and makes its own gravy.
    This recipe will make 8-10 servings, depending on how hungry your eaters are.
    Ingredients:
    4 pounds chuck roast
    salt and pepper to taste
    5 tablespoons dry onion soup mix (recipe below)
    1 (18 ounce) can Progresso creamy mushroom soup (it's gluten-free!)
    1 cup water
    3 carrots, chopped
    1 onion, chopped
    3 potatoes, peeled and cubed
    1 stalk celery, chopped
    Directions:
    Season the roast with salt and pepper to taste. Brown on all sides in a large skillet over high heat, about 4 minutes per side.
    Place the roast in the slow cooker and add the soup mix, water, carrots, onion, potatoes, and celery.
    Cook on High setting for 3 to 4 hours, or on Low setting for 8 to 10 hours.

    Dry Onion Soup Recipe
    Ingredients:
    ¾ cup dried minced onion
    ½ cup gluten-free beef soup stock mix (I use Full Flavor Foods brand)
    ¼ cup onion powder
    Combine all ingredients. Store in an airtight container.
    Use 5 tablespoons of dry mix to equal one envelope of onion soup mix.

    Jefferson Adams
    Shepherd's pie is one of my favorite comfort foods. It brings together meat, potatoes cheese and veggies for a simple, satisfying meal that will also help to warm up the house on a cool day.
    Here is a recipe for a delicious, gluten-free shepherd's pie that is quick, easy to make, and sure to please most meat and potato lovers.
    Ingredients:
    1½ pounds lean ground beef 6 large potatoes, peeled and cubed 1 medium onion, chopped ¼ cup shredded sharp cheddar cheese 4 carrots, peeled and chopped 1 (14.5 oz) can Fire Roasted Diced Tomatoes, drained 1 tablespoon vegetable oil 1 cup frozen peas, thawed ½ cup whole milk 1 cup gluten-free chicken or beef broth 1 teaspoon chopped fresh or dry rosemary 1 teaspoon chopped fresh or dry thyme 1 tablespoon chopped Italian parsley 1 tablespoon balsamic vinegar 1 tablespoon tomato paste 2 tablespoons potato flour (other other gluten-free flour) 4 tablespoons butter, unsalted 2 tablespoons sour cream Directions:
    Heat oven to 375°F.
    In a large pot of salted water, boil potatoes and cook until tender, about 20 minutes.
    Drain potatoes and mash with butter, milk and sour cream. Season with salt and pepper to taste; set aside.
    Heat oil in a large sauté pan over medium-high heat. Add the onions, carrots, and beef. Cook until browned, 8 to 10 minutes.
    Drain away the fat and add the broth, vinegar, tomato paste, diced tomatoes, and herbs. Simmer about 10 minutes, strain away any excess liquid, mix in the flour, and then add the peas. Mix well.
    Pour the mixture into a large glass baking dish.
    Spread potatoes over the meat mixture, then crosshatch the top with a fork. Top with cheddar cheese.
    Bake until golden brown on top, 30 to 35 minutes.

    Jefferson Adams
    Like chicken? Like mushrooms? Looking for a quick, delicious meal that will put smiles on the faces at your table?
    Here is a recipe for chicken breast that relies on a few simple ingredients to deliver a tasty meal that will make for happy eaters, and leave you with plenty of time to spend doing something besides cooking. This chicken breast goes great with rice or potatoes.
    Ingredients:
    4 skinless, boneless chicken breast halves - pounded thin
    8-10 fresh brown mushrooms, sliced
    3 tablespoons unsalted butter, divided
    1 tablespoon olive oil
    2 shallots, chopped
    2 clove garlic, sliced
    ⅓ cup dry sweet white vermouth
    ½ cup chicken broth
    salt and pepper to taste
    Directions:
    Heat olive oil and butter in a large skillet over medium heat.
    Season chicken with salt and pepper, and brown on both sides in the skillet. Cover, and cook another 10 minutes, or until chicken juices run clear. Set aside, and keep warm.
    Mix mushrooms, shallots and garlic into skillet over medium heat, and cook until tender. Stir in vermouth, and cook until heated through. Stir in broth, and cook another 5 minutes or so, until reduced and slightly thickened. Add remaining butter, and stir until melted.
    Spoon the sauce over the chicken, and serve.

    Jefferson Adams
    Celiac.com 04/19/2016 - Blackened Redfish is a Cajun classic that can also be prepared quite nicely with the much easier to find Tilapia. This recipe delivers a tasty, flavorful version of blackened fish that pairs well with slow cooked red beans and rice. It's easy to make at the end of a long day. Just cook the fish and rice, and serve up the beans.
    Blackened Fish
    Ingredients:
    4 tilapia fillets 1 cup long-grain white rice 2 cups fresh flat-leaf Italian parsley 1 teaspoon grated lemon zest 3 tablespoons olive oil 3 tablespoons paprika ¾ teaspoon garlic powder ¾ teaspoon dried thyme ¼ teaspoon cayenne pepper 2 tablespoons fresh lemon juice Kosher salt and pepper Lemon Wedges Directions:
    Cook the rice according to package directions. Meanwhile, in a food processor, pulse the parsley, lemon zest, 2 tablespoons oil, and 1/4 teaspoon each salt and pepper until finely chopped; set aside.
    In a small bowl, stir together the paprika, garlic powder, thyme, cayenne, ½ teaspoon salt, and ¼ teaspoon pepper. Brush the lemon juice over the fish, then coat in the spice mixture.
    Heat the remaining tablespoon oil in a large skillet over medium heat. Cook the fish in two batches, adding extra oil if necessary, until the fish is beginning to blacken and is opaque throughout, 2 to 3 minutes per side.
    Fluff the rice with a fork and fold in the parsley mixture. Serve with the fish and lemon wedges, if desired.
    Slow Cooked Red Beans and Rice
    Ingredients:
    1 pound andouille sausage, sliced into rounds 1 large sweet onion, chopped 1 green bell pepper, chopped 1-2 tablespoon gluten-free red pepper sauce, to taste (optional) 8 cloves garlic, chopped 1 teaspoon ground black pepper 1 teaspoon Creole seasoning, or to taste 6 fresh basil leaves, chopped 1 ham hock 4 cups cooked rice Place the beans and water into a slow cooker.
    Heat a skillet over medium-high heat.
    Brown the sausage in the skillet; remove from the skillet with a slotted spoon and transfer to the slow cooker. Reserve drippings.
    Add onion, green pepper, red pepper sauce and garlic to the drippings; cook and stir until tender, about 5 minutes.
    Transfer everything from the skillet to the slow cooker.
    Season the mixture with pepper and Creole seasoning.
    Add the fresh basil leaves and ham hock.
    Cover and cook on low for about 8 hours, until beans are tender.
    Cook until beans reach a creamy texture.

  • Recent Articles

    Jefferson Adams
    Celiac.com 06/19/2018 - Could baking soda help reduce the inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease? Scientists at the Medical College of Georgia at Augusta University say that a daily dose of baking soda may in fact help reduce inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease.
    Those scientists recently gathered some of the first evidence to show that cheap, over-the-counter antacids can prompt the spleen to promote an anti-inflammatory environment that could be helpful in combating inflammatory disease.
    A type of cell called mesothelial cells line our body cavities, like the digestive tract. They have little fingers, called microvilli, that sense the environment, and warn the organs they cover that there is an invader and an immune response is needed.
    The team’s data shows that when rats or healthy people drink a solution of baking soda, the stomach makes more acid, which causes mesothelial cells on the outside of the spleen to tell the spleen to go easy on the immune response.  "It's most likely a hamburger not a bacterial infection," is basically the message, says Dr. Paul O'Connor, renal physiologist in the MCG Department of Physiology at Augusta University and the study's corresponding author.
    That message, which is transmitted with help from a chemical messenger called acetylcholine, seems to encourage the gut to shift against inflammation, say the scientists.
    In patients who drank water with baking soda for two weeks, immune cells called macrophages, shifted from primarily those that promote inflammation, called M1, to those that reduce it, called M2. "The shift from inflammatory to an anti-inflammatory profile is happening everywhere," O'Connor says. "We saw it in the kidneys, we saw it in the spleen, now we see it in the peripheral blood."
    O'Connor hopes drinking baking soda can one day produce similar results for people with autoimmune disease. "You are not really turning anything off or on, you are just pushing it toward one side by giving an anti-inflammatory stimulus," he says, in this case, away from harmful inflammation. "It's potentially a really safe way to treat inflammatory disease."
    The research was funded by the National Institutes of Health.
    Read more at: Sciencedaily.com

    Jefferson Adams
    Celiac.com 06/18/2018 - Celiac disease has been mainly associated with Caucasian populations in Northern Europe, and their descendants in other countries, but new scientific evidence is beginning to challenge that view. Still, the exact global prevalence of celiac disease remains unknown.  To get better data on that issue, a team of researchers recently conducted a comprehensive review and meta-analysis to get a reasonably accurate estimate the global prevalence of celiac disease. 
    The research team included P Singh, A Arora, TA Strand, DA Leffler, C Catassi, PH Green, CP Kelly, V Ahuja, and GK Makharia. They are variously affiliated with the Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Lady Hardinge Medical College, New Delhi, India; Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway; Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Gastroenterology Research and Development, Takeda Pharmaceuticals Inc, Cambridge, MA; Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy; Department of Medicine, Columbia University Medical Center, New York, New York; USA Celiac Disease Center, Columbia University Medical Center, New York, New York; and the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
    For their review, the team searched Medline, PubMed, and EMBASE for the keywords ‘celiac disease,’ ‘celiac,’ ‘tissue transglutaminase antibody,’ ‘anti-endomysium antibody,’ ‘endomysial antibody,’ and ‘prevalence’ for studies published from January 1991 through March 2016. 
    The team cross-referenced each article with the words ‘Asia,’ ‘Europe,’ ‘Africa,’ ‘South America,’ ‘North America,’ and ‘Australia.’ They defined celiac diagnosis based on European Society of Pediatric Gastroenterology, Hepatology, and Nutrition guidelines. The team used 96 articles of 3,843 articles in their final analysis.
    Overall global prevalence of celiac disease was 1.4% in 275,818 individuals, based on positive blood tests for anti-tissue transglutaminase and/or anti-endomysial antibodies. The pooled global prevalence of biopsy-confirmed celiac disease was 0.7% in 138,792 individuals. That means that numerous people with celiac disease potentially remain undiagnosed.
    Rates of celiac disease were 0.4% in South America, 0.5% in Africa and North America, 0.6% in Asia, and 0.8% in Europe and Oceania; the prevalence was 0.6% in female vs 0.4% males. Celiac disease was significantly more common in children than adults.
    This systematic review and meta-analysis showed celiac disease to be reported worldwide. Blood test data shows celiac disease rate of 1.4%, while biopsy data shows 0.7%. The prevalence of celiac disease varies with sex, age, and location. 
    This review demonstrates a need for more comprehensive population-based studies of celiac disease in numerous countries.  The 1.4% rate indicates that there are 91.2 million people worldwide with celiac disease, and 3.9 million are in the U.S.A.
    Source:
    Clin Gastroenterol Hepatol. 2018 Jun;16(6):823-836.e2. doi: 10.1016/j.cgh.2017.06.037.

    Jefferson Adams
    Celiac.com 06/16/2018 - Summer is the time for chips and salsa. This fresh salsa recipe relies on cabbage, yes, cabbage, as a secret ingredient. The cabbage brings a delicious flavor and helps the salsa hold together nicely for scooping with your favorite chips. The result is a fresh, tasty salsa that goes great with guacamole.
    Ingredients:
    3 cups ripe fresh tomatoes, diced 1 cup shredded green cabbage ½ cup diced yellow onion ¼ cup chopped fresh cilantro 1 jalapeno, seeded 1 Serrano pepper, seeded 2 tablespoons lemon juice 2 tablespoons red wine vinegar 2 garlic cloves, minced salt to taste black pepper, to taste Directions:
    Purée all ingredients together in a blender.
    Cover and refrigerate for at least 1 hour. 
    Adjust seasoning with salt and pepper, as desired. 
    Serve is a bowl with tortilla chips and guacamole.

    Dr. Ron Hoggan, Ed.D.
    Celiac.com 06/15/2018 - There seems to be widespread agreement in the published medical research reports that stuttering is driven by abnormalities in the brain. Sometimes these are the result of brain injuries resulting from a stroke. Other types of brain injuries can also result in stuttering. Patients with Parkinson’s disease who were treated with stimulation of the subthalamic nucleus, an area of the brain that regulates some motor functions, experienced a return or worsening of stuttering that improved when the stimulation was turned off (1). Similarly, stroke has also been reported in association with acquired stuttering (2). While there are some reports of psychological mechanisms underlying stuttering, a majority of reports seem to favor altered brain morphology and/or function as the root of stuttering (3). Reports of structural differences between the brain hemispheres that are absent in those who do not stutter are also common (4). About 5% of children stutter, beginning sometime around age 3, during the phase of speech acquisition. However, about 75% of these cases resolve without intervention, before reaching their teens (5). Some cases of aphasia, a loss of speech production or understanding, have been reported in association with damage or changes to one or more of the language centers of the brain (6). Stuttering may sometimes arise from changes or damage to these same language centers (7). Thus, many stutterers have abnormalities in the same regions of the brain similar to those seen in aphasia.
    So how, you may ask, is all this related to gluten? As a starting point, one report from the medical literature identifies a patient who developed aphasia after admission for severe diarrhea. By the time celiac disease was diagnosed, he had completely lost his faculty of speech. However, his speech and normal bowel function gradually returned after beginning a gluten free diet (8). This finding was so controversial at the time of publication (1988) that the authors chose to remain anonymous. Nonetheless, it is a valuable clue that suggests gluten as a factor in compromised speech production. At about the same time (late 1980’s) reports of connections between untreated celiac disease and seizures/epilepsy were emerging in the medical literature (9).
    With the advent of the Internet a whole new field of anecdotal information was emerging, connecting a variety of neurological symptoms to celiac disease. While many medical practitioners and researchers were casting aspersions on these assertions, a select few chose to explore such claims using scientific research designs and methods. While connections between stuttering and gluten consumption seem to have been overlooked by the medical research community, there is a rich literature on the Internet that cries out for more structured investigation of this connection. Conversely, perhaps a publication bias of the peer review process excludes work that explores this connection.
    Whatever the reason that stuttering has not been reported in the medical literature in association with gluten ingestion, a number of personal disclosures and comments suggesting a connection between gluten and stuttering can be found on the Internet. Abid Hussain, in an article about food allergy and stuttering said: “The most common food allergy prevalent in stutterers is that of gluten which has been found to aggravate the stutter” (10). Similarly, Craig Forsythe posted an article that includes five cases of self-reporting individuals who believe that their stuttering is or was connected to gluten, one of whom also experiences stuttering from foods containing yeast (11). The same site contains one report of a stutterer who has had no relief despite following a gluten free diet for 20 years (11). Another stutterer, Jay88, reports the complete disappearance of her/his stammer on a gluten free diet (12). Doubtless there are many more such anecdotes to be found on the Internet* but we have to question them, exercising more skepticism than we might when reading similar claims in a peer reviewed scientific or medical journal.
    There are many reports in such journals connecting brain and neurological ailments with gluten, so it is not much of a stretch, on that basis alone, to suspect that stuttering may be a symptom of the gluten syndrome. Rodney Ford has even characterized celiac disease as an ailment that may begin through gluten-induced neurological damage (13) and Marios Hadjivassiliou and his group of neurologists and neurological investigators have devoted considerable time and effort to research that reveals gluten as an important factor in a majority of neurological diseases of unknown origin (14) which, as I have pointed out previously, includes most neurological ailments.
    My own experience with stuttering is limited. I stuttered as a child when I became nervous, upset, or self-conscious. Although I have been gluten free for many years, I haven’t noticed any impact on my inclination to stutter when upset. I don’t know if they are related, but I have also had challenges with speaking when distressed and I have noticed a substantial improvement in this area since removing gluten from my diet. Nonetheless, I have long wondered if there is a connection between gluten consumption and stuttering. Having done the research for this article, I would now encourage stutterers to try a gluten free diet for six months to see if it will reduce or eliminate their stutter. Meanwhile, I hope that some investigator out there will research this matter, publish her findings, and start the ball rolling toward getting some definitive answers to this question.
    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
    Celiac.com 06/14/2018 - Refractory celiac disease type II (RCDII) is a rare complication of celiac disease that has high death rates. To diagnose RCDII, doctors identify a clonal population of phenotypically aberrant intraepithelial lymphocytes (IELs). 
    However, researchers really don’t have much data regarding the frequency and significance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. Such data could provide useful comparison information for patients with RCDII, among other things.
    To that end, a research team recently set out to try to get some information about the frequency and importance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. The research team included Shafinaz Hussein, Tatyana Gindin, Stephen M Lagana, Carolina Arguelles-Grande, Suneeta Krishnareddy, Bachir Alobeid, Suzanne K Lewis, Mahesh M Mansukhani, Peter H R Green, and Govind Bhagat.
    They are variously affiliated with the Department of Pathology and Cell Biology, and the Department of Medicine at the Celiac Disease Center, New York Presbyterian Hospital/Columbia University Medical Center, New York, USA. Their team analyzed results of TCR-GR analyses performed on SB biopsies at our institution over a 3-year period, which were obtained from eight active celiac disease, 172 celiac disease on gluten-free diet, 33 RCDI, and three RCDII patients and 14 patients without celiac disease. 
    Clonal TCR-GRs are not infrequent in cases lacking features of RCDII, while PCPs are frequent in all disease phases. TCR-GR results should be assessed in conjunction with immunophenotypic, histological and clinical findings for appropriate diagnosis and classification of RCD.
    The team divided the TCR-GR patterns into clonal, polyclonal and prominent clonal peaks (PCPs), and correlated these patterns with clinical and pathological features. In all, they detected clonal TCR-GR products in biopsies from 67% of patients with RCDII, 17% of patients with RCDI and 6% of patients with gluten-free diet. They found PCPs in all disease phases, but saw no significant difference in the TCR-GR patterns between the non-RCDII disease categories (p=0.39). 
    They also noted a higher frequency of surface CD3(−) IELs in cases with clonal TCR-GR, but the PCP pattern showed no associations with any clinical or pathological feature. 
    Repeat biopsy showed that the clonal or PCP pattern persisted for up to 2 years with no evidence of RCDII. The study indicates that better understanding of clonal T cell receptor gene rearrangements may help researchers improve refractory celiac diagnosis. 
    Source:
    Journal of Clinical Pathologyhttp://dx.doi.org/10.1136/jclinpath-2018-205023