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    When Battling Boredom Consider Camps for Your Gluten-Free Little One by Danna Korn


    Danna Korn

    This article originally appeared in the Summer 2002 edition of Celiac.coms Scott-Free newsletter.
    Copyright © 2002 Scott Adams. All rights reserved worldwide.


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    Celiac.com 07/28/2005 - Being gluten-free shouldnt change your summer plans. For a kid, absolutely nothing compares to the excitement of counting down those last few days before school is out for summer, and life goes from routine and imprisoning to lazy and carefree. Thats right—sing it now—schools out for summer!

    We parents, admittedly, have some mixed emotions about summer break. We eagerly await the mornings free of chaos and last-minute-I-have-nothing-to-wear tantrums, evenings without battles over homework, and afternoons when kids will have more time to play, and maybe even to help around the house and yard (a mom can dream, cant she?).

    But summer break is a catalyst for new battles, such as trying to explain to our kids that yes, it is your summer vacation, and yes, it is supposed to be relaxing, but 16 hours of television is still too much. The first few days are what I call freebies. We all enjoy the lack of structure, allowing our little ones to sleep as long as theyd like (but why is it that on school days they whine that they could have slept until noon, and during summer break theyre up at the crack of dawn?), and even buying into the oh-so-well-presented argument that this is just the first (second, third) day of vacation, and its the only day theyll watch TV all summer—promise! Energized by the contagious enthusiasm of summer break, we pack weeks worth of fun into the first few days, and revel in every minute of family freedom.

    And then...by about day four...you hear those dreaded two words that can, in and of themselves, induce critically high blood-pressure levels faster than anchovies on crackers: Im bored!

    Most parents go into the summer with good intentions and the best-laid plans for staving off the boredom blues. Fun-but-educational math and science workbooks, fun family fitness programs, and a well-stocked arts and crafts cabinet can sound like a good idea, but kids (and adults!) just want to have fun. The difference is that adults have responsibilities and obligations, and cant usually put our lives on hold for three months. They, however, can—and should.

    But my kids are gluten-free....
    Oh, good point. That just means you may have to be a smidge more creative, but basically, if your child cant eat gluten, your options for battling boredom are just the same as everyone elses. Yep. Just the same. You may have to be a little more creative, and youll undoubtedly need to spend time educating those around you. But its well worth the time and energy to provide your child with some of lifes greatest summer experiences and memories.

    You may want to consider summer camps. Both day and away camps offer tremendous opportunities and experiences. There are some wonderful specialty camps for celiac kids, but dont feel that your options are limited to those. Do you think its too hard because of your childs diet? Think again!

    Day Camps/Away Camps—Gluten-Freedom!
    Sending your child away to camp is difficult. Oh—dont misunderstand me—its not difficult because of the diet. Its saying good-bye thats the hard part!

    Whether you choose day camps or away camps is up to you. From a dietary standpoint, the concept is the same. You may want to take all the worry out of it and send your child to a camp specially designed for celiac kids. Three are listed at the end of this article. But dont think youre limited to specialty camps. You can send them to any camp if you keep a few important things in mind:

    • Educate the counselors/cooks in advance.
      If possible, meet with the head counselor in person to discuss your childs dietary requirements. Ideally, you should meet with the nutritional director or chef, too. Youll probably be surprised at how receptive they are. Most camps are accustomed to accommodating conditions such as diabetes or severe allergies, and are glad to learn the intricacies of the gluten-free diet.
      Make sure you give them plenty of time to make arrangements for your childs dietary needs. Meet several weeks in advance so they can plan, prepare, understand, and adapt menus. Remember to discuss preparation techniques, so they understand how to avoid cross-contamination during preparation and serving.
    • Send reference information.
      Make sure the counselors and cooks have printed copies of safe and forbidden food lists. They can be found at Celiac.com, or send them with a copy of Kids with Celiac Disease. These resources will be important if there are questions about ingredients or special treats, and if they take the time to read more about celiac disease, you will have educated someone on the subject, and that is also important.
    • Make sure your child understands his diet.
      If youve read Kids with Celiac Disease or heard me speak, you know that Im a downright nag when it comes to giving your child control of his diet. Its crucial! But in this case, its also key to ensuring a safe and enjoyable camp experience. Remember, if you dont give your child control of his diet, his diet may control him.
    • Send food.
      Dont rely upon the camp to provide specialty gluten-free foods like bread and pasta. Theyre expensive and difficult to get, but more importantly, its not up to others to accommodate your childs diet (another "nagging point" of mine). Be sure to send mixes for cookies, brownies, and other treats, if they have the facilities to prepare them. These days, the specialty mixes you can buy are so good that your childs treats are likely to be the hit of the camp.

    More than simply a great way to beat the summertime boredom blues, sending your child to camp can be a huge growing-up experience. Oh—and the kids will do some growing up, too!

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    Guest Jeanne Branick

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    I talked to the director of Omega Teen Camp in New York and asked if I could send gluten-free pancake mix and other items and he said no, they couldn't do that. He did say he could bring his own cookies and crackers. I asked to speak directly with the chef/cook and he said everything goes through him. This is suppose to be a wonderful holistic healthy camp. What are my options at this point? By the way, my teenage son is not celiac but gluten/gliadin intolerant and dairy intolerant, but can take enzymes if he occasionally eats dairy and he's alright. thank you

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    Guest Sue Lein

    Posted

    I own a summer camp for girls and boys age 8 -15 and can support children on gluten free diets. I have an food allergy policy in place and meet with each family to identify individual needs. Of course you can send special food. We have quite a few at camp. We are the ultimate flexible camp. I'd like to spread the word. Any suggestions?

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    Guest Bonny Huston

    Posted

    Doctors have discovered a correlation between diabetes and celiac disease. I have three children with celiac, and one with celiac and diabetes. The two camps I am the nurse at, as well as many of the other diabetes camp I have networked with, are very sensitive to gluten free diets. The key is to speak to the camp director, medical staff, and then the kitchen staff. All three need to work together to offer a safe camp for children with any food allergy.

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    Danna Korn
    The key to gluten-free cooking is simple: take a little bit of homework on your part, a dash of extra effort, and dump in a whole lot of creativity - voila! You're a gluten-free gourmet! But some of the greatest culinary challenges are for those meals-on-the-run, which seem to be the most common kind sometimes. Kids with Celiac Disease has extensive menu suggestions for all meals and snacks, but the following is a short excerpt of on-the-go snack ideas:
    Chips There are many flavors of gluten-free chips available at grocery stores! string cheese Taquitos, quesadillas, tacos, tamales (made with corn tortillas - they travel well) Nachos Corn Nuts Raisins and other dried fruit Chex mix There is a gluten-free cereal available at many grocery stores or health food markets thats just like Chex--make the mix as you would Chex mix. Popcorn Cheese cubes with toothpicks in them and rice crackers Fruit rolls Lettuce wrapped around ham, cheese, turkey, or roast beef Rice cakes (check with the manufacturer; not all are gluten-free) Hard-boiled eggs or deviled eggs Applesauce Apples dipped in caramel or peanut butter (if youre sending apples in a lunchbox, remember to pour lemon juice over the slices; that will keep them from turning brown) Individually packaged pudding Jello Yogurt Fruit cups (individually packaged cups are great for lunchboxes) Fruit snacks (like Farleys brand) High-protein bars (e.g., Tigers Milk, GeniSoy) Nuts Marshmallows Trail mix Combine peanuts, M&Ms, dried fruit, chocolate chips, and other trail mix items for a great on-the-go snack.
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    Danna Korn
    This article appeared in the Spring 2005 edition of Celiac.coms Scott-Free Newsletter.
    Celiac.com 06/08/2005 – Theres no point in enjoying the improved health and vitality youll experience on a gluten-free diet if youre just sitting at home pining away for excitement because youre afraid to venture too far away. You have to live life to its fullest—you should be livin la vida loca! Theres no reason whatsoever to limit or, worse yet, give up travel because of this diet. Traveling wheat-free/gluten-free might be a little intimidating at first, but really, it just takes a little more planning, and sometimes an extra suitcase or two.
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    Before you leave, research your destination: Check with a support group in the area youre visiting to see if they have a list of celiac-friendly restaurants or grocery stores. Also search the St. Johns Celiac Listserv archives for frequent posts about gluten-free-friendly restaurants. You might want to go to the Internet and look up your destination city to see if they have one or more health food stores. If they do, call the store(s) and ask what gluten-free products they carry—if you have a favorite product, ask them to order it for you before your trip so they will have it in stock when you arrive.
    Be aware of legal considerations when crossing borders: Some countries have laws about what foods can be imported. Make sure you know what the laws are, and dont try to bring foods with you that might be confiscated. My family and I had an – umm – interesting experience at the Mexican border when we brought gluten-free pancake mix in an unmarked, vacuum-sealed plastic bag.
    Know the language (at least key words): Learn at least a few key words of the language spoken in the country youll be visiting. Make sure you can say wheat, flour, and other key words. Bring restaurant cards written in the language(s) of the country youre visiting (see www.celiactravel.com), or use translation software to create your own. Ask for rooms with a kitchenette, or stay in a condo: Even a small kitchenette with a microwave, refrigerator, and sink will make your life a little easier.
    Ship food to yourself: If youre traveling a long distance or are going to be gone for a long period of time, consider shipping some of your favorite products to your ultimate destination so theyre waiting for you when you arrive.
    Carry a "kitchen in a suitcase": If youre accustomed to making your breads, cookies, and other baked goods from the mixes that you order online or find in specialty stores, bring them with you, as it may be difficult to find them at your ultimate destination. Bring your specialty tools or appliances, too, like your bread slicer, if you plan on cooking while youre away.
    Grab your gadgets: Manufacturers offer some ultra-convenient travel gadgets these days, even for the traveling eater. Most sporting goods stores carry a small refrigerator (there are several brands) that plugs into the cigarette lighter of your car, making it easier to bring yogurt and other perishables on long drives. And we all know how toasters can present a problem since "regular" toast seems to spray its crumbs everywhere, contaminating them for gluten-free eaters. A travel toaster available on the Internet:
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    BYOF: Even gluten-free bread travels well if you slice it and pack it in a hard plastic storage container. Hard-to-find cereals, pretzels, and favorite treats—even pre-baked frozen cookies—make great snacks en route or when you arrive. Dont forget to pack food for the trip itself, as well as food for your stay at the destination.
    There are grocery stores everywhere you go: When you arrive at your ultimate destination, stop in at the local grocery store and stock up on some of the basics. Dont forget to buy aluminum foil and resealable bags, which work well to store leftovers from restaurants, or any foods that you may have brought with you.
    Remember your restaurant rules: Use the tips mentioned in my books or in past issues of Scott-Free for eating out at restaurants, since youll probably be eating out more than you do when youre at home. If youre traveling to certain places in Europe, you might be pleasantly surprised to find that in some countries like Sweden McDonalds offers two types of hamburger buns: gluten-free and "regular."
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    When planning how and what youre going to eat on your trip, you have to first decide where youre going and how youre going to get there. How much and what you bring depends on whether youre taking planes, trains, or automobiles.
    Driving: Driving allows you the most flexibility, and is easiest when youre trying to accommodate a restricted diet. If youre driving in the United States, there will most certainly be national fast-food chains all along the way. Even if you dont want to rely on greasy burgers and fries as a staple for your entire drive, you know that you have a backup—just in case. National restaurant chains (even those that are not of the fast-food, greasy-burger variety) have branches in all major cities—find out which restaurants are along your driving route (you can check www.mapquest.com or a similar Website), and check the restaurants Web sites or contact them for their lists of wheat-free/gluten-free products (this is where your three-ring binder with restaurant lists that you leave in the car comes in handy). There are also commercial gluten-free restaurant guides available, such as the one at www.celiac.com.
    Most important, BYOF. You will probably bring snack foods to munch on while you drive, so just make sure youre loaded with snacks that are easy to eat in the car, travel well, and of course, meet your dietary restrictions (and dont forget the paper towels or wet wipes!).
    Flying, cruising, and riding the rails: Theres less flexibility in how and where you can eat when youre at the mercy of a commercial airliner, ship, or train—but you still have a number of options. Many commercial airlines offer a selection of specialty meals, including gluten-free ones. Be careful, though, and read the labels if the food has them, because sometimes our gluten-free meals have come with fluffy, doughy bagels (that obviously arent gluten-free). If mistakes are made, dont be mad. They tried, and at least they considered having a gluten-free meal as an option. Be glad they made the attempt, and consider writing a polite, gratuitous letter to the food supplier offering information on whats gluten-free and what isnt.
    These days, airlines restrict the number of carry-on bags, so youll have to be more efficient in packing snacks and meals for the flight. Snack items that you might include in a sack lunch usually make good take-along foods for the airplane.
    Cruise ships always have executive chefs. Theyre accustomed to accommodating restricted diets, some of which can have dangerous consequences if mistakes are made, so they take the subject very seriously. By contacting the administrative offices of the cruise line several weeks in advance, you can arrange for the chef to provide you gluten-free meals throughout your cruise.
    Trains are tougher, since most of the foods found in café cars are usually along the lines of packaged sandwiches, croissants, pastries, and other oh-so-not-nutritious goodies. I highly recommend bringing food on the train, and not just because of your restricted diet, if you know what I mean.

    Danna Korn
    This article originally appeared in the Winter 2006 edition of Celiac.com's Journal of Gluten-Sensitivity.
    Celiac.com 04/30/2010 - The gluten-free lifestyle is a big part of who we are.  So when friends, relatives, and loved ones don’t get it—I should clarify—when they seem to choose not to get it—we sometimes get a little cranky.
    I know—I was reminded of how it feels when loved ones don’t choose to get it this past Thanksgiving when one of my relatives who shall remain nameless glutenized the mayo jar.  Now I realize it may seem petty to get tweaked about someone dipping a knife in a mayo jar—but it had gluten all over it, and worse yet, she did the same thing last Thanksgiving, and I threw a tizzy about it then.
    Realizing the first dip alone contaminated the entire jar (of course it was the club-sized jar that is the size of a small Volkswagen), there was no point in stopping her from doing it again.  But I watched incredulously as she taunted me, dipping the knife into the jar—then onto the (gluten) bread—over, and over, and over again.  How many gobs of mayo does one need on a piece of bread?!?  I found myself seething, and my blood boiled with every dip-and-spread motion; I swear she was doing it intentionally.
    Yes, I know I should have had a squeeze bottle handy, and I even write about that in my books. My mistake, but I also write about doing the “gob drop,” which is—as the name implies—the process of taking a gob of (insert condiment here) and dropping it onto said piece of gluten.  Using a separate knife, you spread.  It’s really not that tough.
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    This is our lifestyle, and we love it.  Those friends and family who do care enough to call and make sure the meal they’re serving us is gluten-free are to be cherished.  Those who make a special trip to the health food store to buy a mix and make gluten-free cookies are to be downright hailed as saints.  Even those who make a beautiful gluten-free meal and then top it with teriyaki sauce (of the gluten-containing variety) because they don’t know any better are to be adored for trying.
    I write about this stuff in my books, and it surprised me a little to find myself getting miffed about such a petty thing.  I thought I had outgrown those feelings 14 years ago.  I guess my point is that we all face certain challenges from time to time, and we need to put our brightest face forward and meet those challenges with a good attitude, lest they get the best of us.
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    This article originally appeared in the Winter 2004 edition of Celiac.com's Journal of Gluten-Sensitivity.
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    Recently, I was reminded of the way I felt when Tyler was first diagnosed, when a woman with tears in her eyes approached me after one of my talks.  “I know you talk about how we can all learn to live and love this lifestyle, and I appreciate your suggestions for raising happy, healthy, gluten-free kids––but,” she seemed shy and embarrassed to continue, looking at the floor as she asked, “would you mind if I talked directly to Tyler?”
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    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