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    Being Young and Celiac


    Miranda Jade
    Image Caption: Photo: CC--Palliativo

    Celiac.com 06/06/2012 - Celiac disease is an autoimmune disease caused by a reaction to the component of wheat, barley, and rye called gluten and can affect the entire body. Dermatitis herpetiformis (DH) is a blistering and extremely itchy skin rash. It’s usually symmetrical in shape and is most commonly located on the elbows, knees, buttocks, and upper back. It’s common for people with DH to have rashes appear in the same spot, and they can either be consistent or come and go.


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    Photo: CC -- PalliativoIt is hard enough being a young adult, having celiac disease is the icing on the cake, and having Dermatitis Herpetiformis is the cherry on top. So how is it that I have been able to so easily make the transition from eating gluten on a daily basis to being 100% gluten-free for over six years now? Simple: by getting educated.

    When I was first diagnosed it was very hard for me. I didn’t know what had gluten in it, what body products to use, etc. My mother Tina Turbin, founder of GlutenFreeHelp.info, gave me some great advice. She told me to do my own research. So I set off to get a real understanding of celiac disease and DH. I was going to have to live with them both my whole life so I felt it couldn’t hurt knowing more about them.

    This was the best advice anyone could have ever given me. With the broad knowledge of celiac disease and DH available these days, I was able to read so much information and get a real grasp of the subjects. I finally was able to easily know which products would have gluten in them and what the gluten actually did internally to my body.

    I really made being gluten-free a priority in my life. I made sure this priority was known among my family and friends as well. They all were more than willing to help. Now, whether going out for brunch with friends or traveling, the people I surround myself with are always picking places where I will have an easy time following my gluten-free diet. Just yesterday, a friend of mine let me know she picked a place for us to eat that would prepare any of their pasta dishes with gluten-free pasta.

    So, my advice to you is this: First, do your own research. There are so many people out there with great advice and so much information to share. The more we join up with others, the easier it will be. Secondly, inform the people you are surrounded with of your dietary needs. Too many people think being gluten-free is just a fad when in reality celiac disease and DH are extremely important and should not be made fun of.

    Last, enjoy life. Living gluten-free can actually be quite fun. The food is delicious and the health benefits are outstanding. Being gluten-free doesn’t have to cause you stress. In fact, by following these guidelines, gluten-free living can become quite rewarding.

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    Guest TysonHolly

    Posted

    I worry that your anecdote of the pasta restaurant making you gluten-free pasta spreads a bit of misinformation, of which I've found the hardest to get people to understand. Gluten-free pasta is great, but what about the counter tops, pots and pans, strainers, handling, etc? This seems to be the hardest concept for my friends and family to understand. I think we can help our loved ones, and ultimately ourselves, by being consistent and educating them on the topic of cross-contamination.

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    Guest apoppy

    Posted

    I worry that your anecdote of the pasta restaurant making you gluten-free pasta spreads a bit of misinformation, of which I've found the hardest to get people to understand. Gluten-free pasta is great, but what about the counter tops, pots and pans, strainers, handling, etc? This seems to be the hardest concept for my friends and family to understand. I think we can help our loved ones, and ultimately ourselves, by being consistent and educating them on the topic of cross-contamination.

    I agree with TysonHolly on the comment about cross-contamination. It is not easy to keep my own kitchen gluten-free with friends and family bringing food to "share" and to eat for themselves. From donuts to buns to cookies and cake, secret ingredients and special recipes galore, there is no end to what people think is safe to bring into my home. I have only managed to eat out just a few times without having a gluten issue. I do not trust ANY kitchen but my own! Once we stayed at a resort that insured me before hand that the chef was well trained in gluten-free cooking. Yes, he was, but his staff failed me and I became very ill, ending our vacation on a bad note with a very uncomfortable trip home. I have celiac disease with severe dermatitis herpetiformis.

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    Guest Annette

    Posted

    I too worry of the cross-contamination in this restaurant. I do not know where she lives, but finding a place to eat out at is, I feel, very difficult. I do not live in or near big cities and this process is daunting. I also have to disagree about the food, other than your fresh fruits, vegetables and meat. A lot of what I have bought that states it is gluten-free tastes horrible, and when the dog won't eat it, you also have to wonder what is in it. I am only two years into knowing I have this disease and I am still learning.

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    Guest andrea lee

    Posted

    I worry that your anecdote of the pasta restaurant making you gluten-free pasta spreads a bit of misinformation, of which I've found the hardest to get people to understand. Gluten-free pasta is great, but what about the counter tops, pots and pans, strainers, handling, etc? This seems to be the hardest concept for my friends and family to understand. I think we can help our loved ones, and ultimately ourselves, by being consistent and educating them on the topic of cross-contamination.

    Thank you for the above comment, for I wholeheartedly agree with you and find this to be the most frustrating thing when reading gluten-free websites. Cross-contamination is so important to living gluten-free with celiac disease, and makes me question any author who does not acknowledge that fact.

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    Guest Miranda Jade Turbin

    Posted

    I worry that your anecdote of the pasta restaurant making you gluten-free pasta spreads a bit of misinformation, of which I've found the hardest to get people to understand. Gluten-free pasta is great, but what about the counter tops, pots and pans, strainers, handling, etc? This seems to be the hardest concept for my friends and family to understand. I think we can help our loved ones, and ultimately ourselves, by being consistent and educating them on the topic of cross-contamination.

    You are totally right. In fact, I got "gluten poisoning" two days ago from cross contamination. Just a tiny bit of gluten can really make you sick. I usually ask restaurants to clean their grill, etc. when I order. If they put up a stink about it, I don't feel safe about eating there and I will leave. For the most part, I find that restaurants in my area are very accommodating.

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    I agree with TysonHolly on the comment about cross-contamination. It is not easy to keep my own kitchen gluten-free with friends and family bringing food to "share" and to eat for themselves. From donuts to buns to cookies and cake, secret ingredients and special recipes galore, there is no end to what people think is safe to bring into my home. I have only managed to eat out just a few times without having a gluten issue. I do not trust ANY kitchen but my own! Once we stayed at a resort that insured me before hand that the chef was well trained in gluten-free cooking. Yes, he was, but his staff failed me and I became very ill, ending our vacation on a bad note with a very uncomfortable trip home. I have celiac disease with severe dermatitis herpetiformis.

    What is severe dermatitis herpetiformis? What reactions are there when you have dermatitis herpetiformis?

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  • Related Articles

    Dyani Barber
    Celiac.com 04/12/2011 - Paul Seelig was found guilty today of 23 counts of obtaining property by false pretense after a two-week trial in Durham, NC. The jury found that he illegally represented baked goods as gluten-free, but they actually contained gluten. Mr. Seelig received an 11 year prison sentence for his crimes, which included the sickening of more than two dozen customers, one of whom had a premature delivery that was possibly caused by her involuntary gluten consumption.
    Seelig's company, Great Specialty Products, purchased regular gluten-containing items from companies in New Jersey such as Costco, and then repackaged them in his home kitchen and sold them as "gluten-free" at the NC State Fair, various street fairs and via home delivery. Seelig claimed that his baked items were homemade in his company's 150,000-square-foot commercial kitchen, and that his company raised its own grains on its 400-acre farm. High gluten levels were detected by both customers and investigators in Seelig's supposedly gluten-free bread, even though he claimed that he tested his bread weekly for gluten and found none. Mr. Seelig could not produce any of his test results at trial.
    Source:

    http://www.newsobserver.com/2011/04/12/1123724/bread-seller-lied-jurors-find.html

    Jefferson Adams
    Celiac.com 03/29/2013 - Parents of children with food allergies can take heart in recent developments at the federal level that are mandating changes in the ways colleges and universities address food-allergy issues in their students.
    A recent federal civil rights settlement between the Department of Justice and Lesley University that arose from Lesley's failure to provide gluten-free food shows that traditional one-style-fits-all dining options are no longer an ­option for our institutions of higher learning.
    The settlement requires Lesley to “continually provide” students with gluten-free dining options and pay $50,000 in damages to ensure the university is in compliance with a federal law that protects people with disabilities.
    As a result, more and more universities are scrambling to make safe food alternatives available to students with severe food allergies, including those with celiac disease, as required by the under the Americans with Disabilities Act.
    This adjustment includes gluten-free food offerings, and colleges and universities in Massachusetts are among the first to attempt the adjustment. Their approaches differ slightly, but the goal is to provide a safe, reliable dining experience to students with food allergies.
    The University of Massachusetts Boston and Boston University have created gluten-free zones in cafeterias and food courts, while others are taking a more individual approach. Tufts and Harvard University, for example, are having nutritionists and dining hall staff work with students to figure out what prepared foods can and cannot be eaten and ordering specialty items as necessary.
    Tufts' plan also includes establishing a dedicated freezer-refrigerator unit in its two dining halls that is stocked with gluten-free foods. The units are kept locked, and only students with special dietary needs are given keys
    UMass Amherst publishes dining hall menus online, and identifies gluten-free offerings with a special icon. The school also has an extensive handout on what foods to avoid and whom to contact if students need gluten-free food.
    About a year ago, UMass Boston created a gluten-free zone in its food court, with a dedicated refrigerator, microwave, and toaster to minimize the risk of contamination.
    Look for the trend to continue as more and more colleges deal with the new legal realities of feeding students who have food allergies.
    Sources:
    http://www.bostonglobe.com/metro/2013/01/16/college-dining-halls-latest-challenge-gluten-free/ZGWMFABp0ruPI87L8BV8wM/story.html http://www.dailynebraskan.com/news/article_32cd62de-6908-11e2-951f-0019bb30f31a.html

    Jefferson Adams
    Celiac.com 11/01/2013 - Dairy and gluten contain "opioid peptides," that belong to the same family as opium. Dairy products contain small amounts of casomorphin, while gluten contains small amounts of gluten exorphin, and gliadorphin/gluteomorphin.
    When peptides from either gluten or casein react with opiate receptors in the brain, they produce effects similar to opiate drugs, such as heroin and morphine, albeit on a much more subtle level.
    These receptors influence the part of the brain involved with speech and auditory integration, which means this part of the brain can cause addiction to foods, spacing out or having foggy brain, migraines/headaches, sleepiness, chronic fatigue, aggressive behavior, moodiness, anxiety, depression, and high tolerance to pain.
    Little research exists on the potentially addictive qualities of gluten and dairy. However, there is plenty of research to back up how a gluten-free and casein-free diet can help improve those who suffer from ADHD, depression, anxiety, OCD, schizophrenia and Autism Spectrum Disorders.
    Many people first beginning a gluten-free and casein-free diet experience withdrawal symptoms, many experience powerful cravings. People can get cranky and irritable, and even pick fights and throw tantrums.
    How do you know if you might be sensitive to gluten or casein?
    Signs that you might be having a reaction to gluten or casein include abnormal bowel movements, either constipated or poorly formed; headaches; aggressive behavior, such as biting, hitting, pushing; inability to focus at school; erratic sleep or rising early -- before 6 a.m.
    Also, if your diet is heavily wheat and dairy based, as many are, it can take up to three weeks to fully be rid of gluten and casein with no reactions.
    If you think you or your child might have an allergy to gluten or casein, you should consider visiting a doctor for an IgG food allergy blood panel to see if that really is the problem. Blood tests are not 100 percent conclusive, but still a good measure.
    If you're still not sure, then ditch all the gluten and dairy in the house, and try a 30-day elimination diet should help return to normal.
    Source:
    Chicagoparent.com

    Jefferson Adams
    Celiac.com 05/25/2015 - Many people who are concerned that they may have celiac disease are not sure where to begin. Many people simply stop eating gluten and call it a day, choosing to avoid what can be a long, drawn-out process of getting an official diagnosis.
    If you suffer from any of the 10 Most Common Complaints of Celiac Patients, you might want to consider the possibility of celiac disease.
    Most doctors, however eager they may be to render proper treatment, are bound by clinical treatment protocols and guidelines that limit the circumstances under which they can order blood screens for celiac disease.
    So, when should doctors test people for celiac disease? According to the American College of Gastroenterology's (ACG) clinical guideline on diagnosis and treatment of celiac disease, people should be tested for celiac disease if they have:
    Signs and symptoms of malabsorption, including chronic diarrhea with weight loss, steatorrhea, abdominal pain after eating, and bloating.
    Or Laboratory evidence of malabsorption, particularly in people who have a first-degree family member with a confirmed celiac disease diagnosis. This includes associated nutritional deficiencies.
    Or A personal history of an autoimmune disease, or an IgA deficiency.
    Or Biopsy-proven DH, iron-deficiency anemia refractory to oral supplementation, or hypertransaminasemia with no other origins. It's interesting to me that the above guidelines don't match up very well with the top ten physical complaints of people who have celiac disease. Those complaints are: Osteopenia/Osteoporosis; Anemia; Cryptogenic hypertransaminasemia; Diarrhea; Bloating; Aphthous stomatitis; Alternating bowel habit; Constipation; Gastroesophageal reflux disease and Recurrent miscarriages.
    What do you think? Do doctors need to have more freedom to conduct blood screens when considering the possibility of celiac disease?
    Source:
    US Pharmacist. 2014;39(12):44-48. 

  • 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