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Splenic Volume Differs in Complicated vs. Non-complicated Celiac Disease

Splenic volume is the key difference between complicated and non-complicated celiac disease.


Photo: CC--Susan

Celiac.com 11/17/2016 - Studies in small groups of patients indicated that splenic volume may be decreased in patients with celiac disease, refractory celiac disease (RCD) type II and enteropathy-associated T-cell lymphoma (EATL).

A team of researchers recently set out to assess splenic volume in a large group of uncomplicated celiac disease, RCD II and EATL patients and in healthy controls. The research team included Tom van Gils, Petula Nijeboer, Jan Hein TM van Waesberghe, Veerle MH Coupé, Kiki Janssen, Jessy A Zegers, Shaikh A. Nurmohamed, Georg Kraal, Sabine CI Jiskoot, Gerd Bouma, Chris JJ Mulder. They are variously affiliated with the Celiac Center Amsterdam, Department of Gastroenterology and Hepatology, the Department of Radiology, the Department of Epidemiology and Biostatistics, the Department of Nephrology, the Department of Molecular Cell Biology and Immunology at VU University Medical Center, Amsterdam, The Netherlands, and with the Department of Radiology, St Jansdal, Harderwijk, The Netherlands.

For their retrospective cohort they included 77 patients with uncomplicated celiac disease (of whom 39 in remission), 29 patients with RCD II, 24 patients with EATL, and 12 patients with both RCD II and EATL. The control group included 149 healthy living kidney donors. The team used computed tomography to determine splenic volume.

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The median splenic volume in the uncomplicated celiac disease group was significantly larger than in controls (202 cm3 (interquartile range (IQR): 154–275) versus 183 cm3 (IQR: 140–232), p = 0.02). After correction for body surface area, age and gender, the ratio of splenic volume in uncomplicated celiac disease versus controls was 1.28 (95% confidence interval: 1.20–1.36; p less than 0.001).

On average, RCD II patients showed smaller splenic volume (118 cm3 (IQR 83–181)) than the median splenic volume in the control group (p less than 0.001).

These results show wide variation in splenic volume among patients. In uncomplicated celiac disease, splenic volume is typically enlarged. Lower splenic volume in RCD II patients may be clinically relevant, given the the compromised immune conditions of these patients.

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I went into menopause at age 42. I didn't know I had celiac until I was 56. Now I know why my menopause was so early.

Have been dealing with splinter hemorrhages on three of my toe nails since February. I did go to my doctor who rightly so did a very complete blood work-up ruling out other diseases such as lupus and RA and referred me to several other doctors to make sure that it was not cancer, endocarditis, or something serious. I went to the doctors. I have done some research on vitamin deficiency and it seems that some link splinter hemorrhages to vitamin C deficiency. For the past 2 1/2 weeks I have been eating 3 clementines a day (in addition to the usual multivitamin that I take) and it seems to be helping the splinter hemorrhages. One has grown out and not returned. Visited my GI doctor today and talked about malabsorption of nutrients as a potential issue. We are doing more blood work and checking nutrient levels. I have to believe it has something to do with the celiac. Sorry I don't have a better answer, but like you am trying to figure this out. Please let me know if you find any answers, and yes, be sure to check with your doctor to rule out anything serious.

You only need one positive on the celiac panel. I tested positive only to the DGP IgA and had a Marsh Stage IIIB intestinal damage. Good luck!

Welcome to the forum. First, you need to get copies of your celiac test to confirm you actually had it done and what the results were. Second, to confirm a diagnosis, you must obtain biopsies via an endoscopy. Were the doctors gastroenterologists? Third you need to research celiac disease. Yes, you can be asymptomatic, but could still have instestinal damage as the small intestine is vast. here is a good place to start: http://www.cureceliacdisease.org/screening/ You might think you are a silent celiac, but ever been anemic? Had your bones checked?

That's good to know about Texas Children's, unfortunately I don't believe they accept our insurance. Our former pediatrician joined with one of their medical groups and we had to find a new one due to insurance. I'll check out their site though.