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Joint Popping And Muscle Twitching?

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I posted about my issues with joint popping a while back, but I wanted to try and again to see if I would get any more responses. Does anyone have chronic joint popping? It started with my wrists and shoulders. I had it a while in my jaw but it went away. However, it never stops in the wrists and shoulders and progressed to my knees, hips, and now neck. Once in a while I can feel my back pop as well.

 

I am curious if there are others experiencing this, how their symptoms have progressed over time, and if they have found a way to address it. I have been off gluten now for about a year and a half. My joint pain in my hands, wrists, and knees is pretty much gone since going gluten free. But, the popping is the one constant. My hip joints hurt because of the popping and if I eat some foods.

 

I've also begun experiencing muscle spasms/twitching in my thighs and arms over the last couple of weeks. I'm wondering if this is a vitamin deficiency or just another unexplained symptom like my popping. 

 

Thanks.

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http://www.hopkinsortho.org/joint_cracking.html

 

Johns Hopkins Sports Medicine Patient Guide to Joint Cracking & Popping

Our Sports Medicine and
Shoulder Surgeons

 

Is cracking and popping of joints normal?

Cracking and popping of joints is usually normal and most of the time is nothing to be concerned about. Strangely enough the exact reason joints pop and snap is not totally understood. One theory is that the ligaments (tethers that hold the bones together) make these noises as they get tight rapidly when the joint is moving. In some instances, popping may be due to a tendon snapping over or around the joint. Another theory is that nitrogen bubbles in the fluid inside the joint are rapidly brought into or out of solution when the joint is manipulated, such as cracking the knuckles in the hand. These noises with movement of a joint, particularly the knee, may sound like folding stiff paper, and are called "crepitus". These noises are increased frequently after surgery on a joint, although the exact reason is not clear.

Do these sounds need to be treated?

Whatever the cause, these sounds do not need to be specifically treated. There are no long term sequelae of these noises, and they do not lead to future problems. There is no basis for the admonition to not crack your knuckles because it can lead to arthritis. There are no supplements or exercises to prevent these noises.

When should I worry about the cracking and popping of a joint?

The only time to worry about cracking or popping of a joint is if there is pain when the joint pops. Swelling is not normal and should be evaluated if it accompanies the noises. If the joint gets locked or stuck when it pops or cracks then it may indicate a joint problem that should be evaluated. If you are losing motion of the joint, if it is swelling or if you are losing function of the joint, then you should seek medical treatment.

 

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My guess is that you're not getting any responses because, at this point in time, joint popping is considered to be normal. It isn't a medical symptom, doesn't cause any damage, and there is no treatment needed unless you have pain, swelling, or a joint gets stuck, which you didn't mention as being an issue.

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My guess is that you're not getting any responses because, at this point in time, joint popping is considered to be normal. It isn't a medical symptom, doesn't cause any damage, and there is no treatment needed unless you have pain, swelling, or a joint gets stuck, which you didn't mention as being an issue.

 

There is pain associated with the popping. I had difficulty lecturing to my class when the jaw popping went on. My hips hurt almost daily from the clicking in them, and when the knee popping gets bad, it is painful. When my wrists pop, they don't generally hurt, but in feels uncomfortable and they feel as if they are locking up at times. Sometimes with a harder snap, it is painful. Same with the shoulders. I don't have noticeable visual swelling, but there is definitely pain involved. 

 

It's not typical, get out of bed popping in the joints that I am experiencing. This is movement in the ligament/tendon issues that was never there 2 years ago and has quickly progressed to different areas of the body.

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There is pain associated with the popping. I had difficulty lecturing to my class when the jaw popping went on. My hips hurt almost daily from the clicking in them, and when the knee popping gets bad, it is painful. When my wrists pop, they don't generally hurt, but in feels uncomfortable and they feel as if they are locking up at times. Sometimes with a harder snap, it is painful. Same with the shoulders. I don't have noticeable visual swelling, but there is definitely pain involved. 

 

It's not typical, get out of bed popping in the joints that I am experiencing. This is movement in the ligament/tendon issues that was never there 2 years ago and has quickly progressed to different areas of the body.

 

 

If it is this debilitating, you must have been to a few doctors about it?  What did the dentist say about the jaw?  Is it out of alignment in some way?  Did he think you have TMJ and need a night guard? Braces to get your bit corrected?   What did the other doctors say?  They are really in a better place to evaluate the issue than we are.  

 

If its not that bad - Have you tried gentle yoga?  Maybe you just need to stretch and use the joints a little.

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My knees and hips crack with pain too.  My knees are getting arthritic from playing too hard in my teens and twenties. I am pretty sure it is a soft tissue problem but I haven't seen a doctor about it yet because I don't want more knee surgery yet.

 

My hips have started to lock, crack and cause me a fair bit of pain in the last year or so. I am guessing it is osteoarthritis and partially due to an odd gait that I have from some partial paralysis down one leg from a back injury.  The hip problem started many months after going gluten-free so I have no idea if it is celiac disease related; I suppose it could be from decades of being undiagnosed - who knows.

 

My joints that get a rheumatic type of arthritis (more upper body) do not crack, they just hurt.

 

To be honest, all of my cracking and pain is getting worse over time. I haven't been to doctors much about it - unless I get surgery or injections into my joints, I do not think there is much that can be done. I'm sort of putting it off because I can't stomach the idea of hip replacement or knee replacements when I am only 40.   :rolleyes:  Sometimes I wish I hadn't played so hard in my youth.  LOL 

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I have had muscle twitching, seems to coincide with my bowel issues / malabsorption when it happens. Most likely a vitamin or mineral deficiency, for me I am thinking it might be potassium because I have ended up in the hospital with low potassium a few times and no other deficiencies have ever shown up on blood tests.

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http://www.hopkinsortho.org/joint_cracking.html

 

Johns Hopkins Sports Medicine Patient Guide to Joint Cracking & Popping

Our Sports Medicine and

Shoulder Surgeons

 

Is cracking and popping of joints normal?

Cracking and popping of joints is usually normal and most of the time is nothing to be concerned about. Strangely enough the exact reason joints pop and snap is not totally understood. One theory is that the ligaments (tethers that hold the bones together) make these noises as they get tight rapidly when the joint is moving. In some instances, popping may be due to a tendon snapping over or around the joint. Another theory is that nitrogen bubbles in the fluid inside the joint are rapidly brought into or out of solution when the joint is manipulated, such as cracking the knuckles in the hand. These noises with movement of a joint, particularly the knee, may sound like folding stiff paper, and are called "crepitus". These noises are increased frequently after surgery on a joint, although the exact reason is not clear.

Do these sounds need to be treated?

Whatever the cause, these sounds do not need to be specifically treated. There are no long term sequelae of these noises, and they do not lead to future problems. There is no basis for the admonition to not crack your knuckles because it can lead to arthritis. There are no supplements or exercises to prevent these noises.

When should I worry about the cracking and popping of a joint?

The only time to worry about cracking or popping of a joint is if there is pain when the joint pops. Swelling is not normal and should be evaluated if it accompanies the noises. If the joint gets locked or stuck when it pops or cracks then it may indicate a joint problem that should be evaluated. If you are losing motion of the joint, if it is swelling or if you are losing function of the joint, then you should seek medical treatment.

 

 

I have linked this page for spirit walk in the past and already told him that he is spending too much worrying about this issue and I am really surprised to see him starting yet another thread about it.  

 

SW

We all have joints that pop. You have nothing wrong with your bones and joints.You told me every specialist has told you this, right?

 

now that you are using your body more, your muscles are responding and they may twitch, but it is not dangerous.

 

You've had all the tests, all the vitamin and mineral tests, so it is not potassium or anything else. 

 

Come on now--what happened to "I am not going to stress over this anymore?"

 

GO OUTSIDE AND PLAY!! :) You are on summer break!

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Irish, that is some good info. My ankles pop all the time, which is super annoying but doesn't cause any problems (other than being loud when you're doing walking meditation or something). I do occassionally get a clicking noise in the back/base of my skull, which is unnerving, but I'm trying to not to worry about it. Good to see it's pretty normal.

 

I do get twitchy/spasming legs, fingers, eyelids sometimes. I've read it might partly be low Vitamin B, so try to take supplements when it gets bad. It tends to happen more in periods after a glutening, but sometimes just happens. Stress contributes to it too (which B12 also helps with).

 

In the grand scheme of things, these are pretty minor annoying issues that I just deal with.

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I pop, crack, twitch, snap, crunch often ^_^  and my spine and neck and brain MRIs....show nothing abnormal.

Osteopaths, spine specialists, rheumies, and orthopedic docs galore have looked at me and said "You have some significant disc degeneration from OA but your spine is ram rod straight and the noises you make and the pain you have comes from being unDxed for so long. Muscles get weak, connective tissue gets impaired and collagen is lost. ..but things may pop and crunch and it's nothing dangerous.".

 

I know this: doing weight-bearing exercise and yoga and healing my gut has proven that things get better in time.

My DEXA scan showed osteopenia 4 years ago, then it showed an improvement 2 years later. It can only get better. 

 

That TV commercial "A body in motion tends to stay in motion"--is not just malarkey.

I have been urging Spirit walk to get moving and stop worrying so much. He has no bone abnormalities,he reports, so...time to stop fretting and

get out and play...If I can do it, he can do it. I'm almost old enough to be his mom, I think . :D

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my toes crack.  usually, when i'm trying to creep out of a room that i have just got the baby to sleep, lolz, it wakes them up.  stoopid noisy toe cracks!  the first baby that happened with is 28 and my toes are still on my feet.  yup, i just checked.  still there :)

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Thanks for the John Hopkins link. Have seen it many times, and it is not describing my particular condition.

 

This is not normal popping that comes from lack of motion. Irish I'm not sure how many times I need to explain this or if I'm simply not explaining it clearly. My bones SNAP. This isn't crackling like when you rise out of bed. My wrist want to lock up, my hips have movement that is painful, and there are times when I've had to use the elevator at my job, b/c my knees hurt so bad from the popping. Another example is that when I'm driving my shoulders snap on a consistent basis simply by turning my steering wheel. I'm forty years old and was on a mountain bike almost daily 3 years ago. I've been active in sports my entire life. I've dislocated my kneecap playing football, broken a wrist in tumbling, and have never had issues with joints until fairly recently. When I started experiencing severe joint pain two years ago, there still was no popping. It started a few months later in my wrists and shoulders and has migrated to other parts of the body. And it is magnified with specific foods, weather, and if I am stressed. So it's not some issue that stems from age, wear and tear, or osteoarthritis.

 

And as I've stated it's extremely difficult to carry on happy-go-lucky when my body is readily available to remind me there is something not right going on.

 

This is the SECOND thread I have posted on this site in over a year asking specifically about joint popping. The first time I posted a thread about it there was one person who responded who seemed to have similar issues. I am curious if there are others. Thanks again.

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That TV commercial "A body in motion tends to stay in motion"--is not just malarkey.

I have been urging Spirit walk to get moving and stop worrying so much. He has no bone abnormalities,he reports, so...time to stop fretting and

get out and play...If I can do it, he can do it. I'm almost old enough to be his mom, I think . :D

 

I move all the time. I teach fourth grade and I am constantly on my feet and moving. I've also been in a great deal of pain over the last two years while working and wondered if I can continue as my symptoms progress. It's very difficult to stop stressing when you're in pain all the time and symptoms are getting worse. I've been doing yoga daily for the last week since out for the summer break. I've been doing a lot to stay stress free. I've been eating well even though I'm not sure how much my body is taking in with the malabsorption issues. 

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This is the SECOND thread I have posted on this site in over a year asking specifically about joint popping. The first time I posted a thread about it there was one person who responded who seemed to have similar issues. I am curious if there are others. Thanks again.

Well.... We can't force people to answer.   :lol:  A few people have answered here, including me. It appears we aren't saying what you want to hear.

Maybe you need a full medical work-up? I think I said something like that earlier though...  

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karen, I've seen numerous doctors and have been a pin cushion for blood work. I've had a joint scan and bone scan. Those were both done a while back though, and this all started two years ago. So I'm not sure what an x-ray would show today on the different joints. The last time I asked about it, there were a few people who gave some good feedback. One person in particular I have PM'd. She doesn't post on the board much and hadn't posted for months though. I guess the idea was to simply see if some new eyes may see my post who have similar issues. I never saw the dentist about TMJ. The popping in the jaw lasted only a few weeks and I feel it every once in a while if I eat things that required a lot chewing (for example whole almonds). The rheumatologists I've seen can't explain the joint popping. One said it was likely due to inflammation in the joints, but I've never experienced swelling. I've more than a handful of doctors who have told me my symptoms are rare and are likely caused by an autoimmune response from the gut. The internist medical doctor I saw at the Mayo Clinic was probably the most helpful of the bunch, and he said there are just a lot of questions about the GI tract don't yet understand. I've abused my body for years with food, so I realize healing takes time. Many of my symptoms have improved. The popping hasn't. It continues to get worse.

 

Ftr, I appreciate all the feedback. I've had several discussions with Irish through PM, so she's more familiar with my symptoms. She's been a great resource.

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karen, I've seen numerous doctors and have been a pin cushion for blood work. I've had a joint scan and bone scan. Those were both done a while back though, and this all started two years ago. So I'm not sure what an x-ray would show today on the different joints. The last time I asked about it, there were a few people who gave some good feedback. One person in particular I have PM'd. She doesn't post on the board much and hadn't posted for months though. I guess the idea was to simply see if some new eyes may see my post who have similar issues. I never saw the dentist about TMJ. The popping in the jaw lasted only a few weeks and I feel it every once in a while if I eat things that required a lot chewing (for example whole almonds). The rheumatologists I've seen can't explain the joint popping. One said it was likely due to inflammation in the joints, but I've never experienced swelling. I've more than a handful of doctors who have told me my symptoms are rare and are likely caused by an autoimmune response from the gut. The internist medical doctor I saw at the Mayo Clinic was probably the most helpful of the bunch, and he said there are just a lot of questions about the GI tract don't yet understand. I've abused my body for years with food, so I realize healing takes time. Many of my symptoms have improved. The popping hasn't. It continues to get worse.

 

Ftr, I appreciate all the feedback. I've had several discussions with Irish through PM, so she's more familiar with my symptoms. She's been a great resource.

 

 

I am very confused now.  It sounded like you could barely talk - but now you say that isn't a big deal.  Doctor's don't see anything unusual in your joints.

 

My joints hurt some because I hadn't been very active.  Moving is what helped me.  But just walking won't help your wrists, for example.  What helped me the most was gentle yoga.  I started in a class for senior citizens at the park and rec - because I moved like a senior citizen.  I have since outgrown that class  but continue to take at least 1 class a week and do some of the exercises at home. Yoga has a way of stretching in a lot of ways.  You think "Wow!  this didn't seem like a hard pose but my ankles are stiff"  then, in a couple of months, you don't notice your ankles are stiff anymore.

 

Oh well....  sorry I can't help.  Maybe this will be helpful to someone else reading this thread at some point.  Good luck.

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I am very confused now.  It sounded like you could barely talk - but now you say that isn't a big deal.  Doctor's don't see anything unusual in your joints.

 

 

I never said neither of those things. I said I had difficulty lecturing when I was experiencing the jaw popping, and I never said it wasn't a big deal.

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I never said neither of those things. I said I had difficulty lecturing when I was experiencing the jaw popping, and I never said it wasn't a big deal.

Sorry. To me, the fact that it went away means it's not something permanent. Maybe just a pulled muscle. The fact that it wasn't bad enough to get it looked at, seemed like it wasn't a big deal any longer.

I officially give up! :). Lol

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Hi SW,

 

Since you are having pain in your hips related to the popping it  makes sense to see a doctor about it.  A rheumatologist is a specialist in issues related to joints and might be able to help.

 

http://www.rheumatology.org/Practice/Clinical/Patients/What_is_a_Rheumatologist_/

 

You also said that certain foods seem to affect the joint popping.  Have you figured out which foods cause the symptoms?  If it is a food related reaction, you can probably figure that out yourself with an elimination diet.

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I agree that a rheumy might be a good idea.  Pains that move and shift to new spots for no apparent reason are not the usual aches and pains.

 

I understand not seeing docs about it - I really dislike going to doctors... a lot.  And some pains the doctors don't see because they move on.  It might take a month or so for pain to really grow enough for me to ask to see a doctor, then it takes a week or so to get into a doctor's office - and they can't do anything for you except prescribe a pain killer to mask pain, forget about getting to to cause. They can refer you to a rheumy though. I did that once and it took 9 months to get in to see her... the pain was totally gone by then because the flare-up ran it's course.   :rolleyes: It came back a year later.LOL

 

I agree with Paul about the food too. Maybe try a food and symptom journal to help you see the trends.

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The thing is guys, Spirit walk has done all that stuff. He tells me he has seen rheumies & orthos &  all manner of doctors. He and I have discussed this many times.

 

It's not a rheumatological or orthopedic problem. 

 

he said: The rheumatologists I've seen can't explain the joint popping.

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The thing is guys, Spirit walk has done all that stuff. He tells me he has seen rheumies & orthos &  all manner of doctors. He and I have discussed this many times.

 

It's not a rheumatological or orthopedic problem. 

 

he said: The rheumatologists I've seen can't explain the joint popping.

 

They haven't been able to explain it which is why I'm reaching out to this community.

 

However Irish, they didn't say it wasn't a rheumatic condition. Well, SOME (I've seen four different ones) have said I don't have arthritis. One said I have inflammatory arthritis and that he could feel inflammation in my joints. The initial rheumatologist I saw said that nothing was showing up in my tests at the time and encouraged me to check into a research hospital or the Mayo Clinic. To be clear, two of those rheumatologists simply reviewed previous blood tests. That is why I went to Mayo. My GI doctor knows that I'm not absorbing fat through fecal tests and said it's certainly possible that I am not getting other nutrients do to malabsorption. They put me on Creon and Zenpep (two pancreatic enzymes) and those didn't change the absorption issues. An odd thing happened earlier this week. My rheumatologist who I hadn't seen since last spring called to check in on me. He asked if any new symptoms have emerged (rashes, swelling, etc). When I told him that the GI doc found that I wasn't absorbing fat and that my stomach lining was reddish (found during upper endoscopy), he said he'd like to be added to their system so he could see my medical records. He said different GI issues are related to joint issues and that it was more pieces to the puzzle.

 

Irish, I've had six straight days of Vinyasa yoga classes, and I feel pretty good. Yoga has been great, and I will continue doing it daily through the summer. I'm still trying to find the culprit to the joint popping. Since removing gluten and changing my diet, most of my symptoms, from the extreme joint pain, to the neuropathy, to the mouth ulcers, seasonal allergies, and energy levels (at least in the mornings) have all improved (although I do have setbacks at times). The one thing that has gotten progressively worse has been the snapping and popping in the joints. What started in the wrists/shoulders moved to the jaw, hips, knees, and now neck. It migrates from hips to knees. I've started feeling my back pop as well, and it's definitely not cool.

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The rheumy can't explain my pains either... for decades they couldn't explain my stomach pains and hypothyroid-like symptoms either.  LOL   Good luck figuring it out. I hope you find some answers.

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I crack, crinkle and twitch. It is totally diet related for me and I know I am way off when I get my eye twitch. This is rare though. Even when my diet is perfect I think I still have damage from years of undiagnosis that there is a bit of damage so there will always be some cracking but no pain.

I had some tomato three weeks ago and now I have a swollen painful knee. I am on a pretty strict diet to keep my arthritis at bay, three years medication free:) and no longer have to get yearly blood testing. Now, I just have to focus and get rid of those nightshades but I love them so so much, way more than gluten to be honest! Oh, and I have to routinely take my supplements - vit D, fish oil, MSM, gluc, B complex and magnesium, which I also fall off track with.

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Oh, about five years ago I had the jaw thing. Not sure if it's the same as you. I had intense swelling and pain where I could hardly open my mouth anymore. My dentist suggested that I pry it as far as I could holding for 30 seconds, many times a day (you could use a cork to hold your mouth open). The next suggestion was the TENS machine. It took months before it felt better but I was also on a regular diet at the time. 

Again, when my diet gets off I get a little tightness in my jaw. This warning gets my diet under control pretty quick as it is very uncomfortable.

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    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.
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    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

    Jefferson Adams
    Celiac.com 06/13/2018 - There have been numerous reports that olmesartan, aka Benicar, seems to trigger sprue‐like enteropathy in many patients, but so far, studies have produced mixed results, and there really hasn’t been a rigorous study of the issue. A team of researchers recently set out to assess whether olmesartan is associated with a higher rate of enteropathy compared with other angiotensin II receptor blockers (ARBs).
    The research team included Y.‐H. Dong; Y. Jin; TN Tsacogianis; M He; PH Hsieh; and JJ Gagne. They are variously affiliated with the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School in Boston, MA, USA; the Faculty of Pharmacy, School of Pharmaceutical Science at National Yang‐Ming University in Taipei, Taiwan; and the Department of Hepato‐Gastroenterology, Chi Mei Medical Center in Tainan, Taiwan.
    To get solid data on the issue, the team conducted a cohort study among ARB initiators in 5 US claims databases covering numerous health insurers. They used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for enteropathy‐related outcomes, including celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy. In all, they found nearly two million eligible patients. 
    They then assessed those patients and compared the results for olmesartan initiators to initiators of other ARBs after propensity score (PS) matching. They found unadjusted incidence rates of 0.82, 1.41, 1.66 and 29.20 per 1,000 person‐years for celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy respectively. 
    After PS matching comparing olmesartan to other ARBs, hazard ratios were 1.21 (95% CI, 1.05‐1.40), 1.00 (95% CI, 0.88‐1.13), 1.22 (95% CI, 1.10‐1.36) and 1.04 (95% CI, 1.01‐1.07) for each outcome. Patients aged 65 years and older showed greater hazard ratios for celiac disease, as did patients receiving treatment for more than 1 year, and patients receiving higher cumulative olmesartan doses.
    This is the first comprehensive multi‐database study to document a higher rate of enteropathy in olmesartan initiators as compared to initiators of other ARBs, though absolute rates were low for both groups.
    Source:
    Alimentary Pharmacology & Therapeutics

    Jefferson Adams
    Celiac.com 06/12/2018 - A life-long gluten-free diet is the only proven treatment for celiac disease. However, current methods for assessing gluten-free diet compliance are lack the sensitivity to detect occasional dietary transgressions that may cause gut mucosal damage. So, basically, there’s currently no good way to tell if celiac patients are suffering gut damage from low-level gluten contamination.
    A team of researchers recently set out to develop a method to determine gluten intake and monitor gluten-free dietary compliance in patients with celiac disease, and to determine its correlation with mucosal damage. The research team included ML Moreno, Á Cebolla, A Muñoz-Suano, C Carrillo-Carrion, I Comino, Á Pizarro, F León, A Rodríguez-Herrera, and C Sousa. They are variously affiliated with Facultad de Farmacia, Departamento de Microbiología y Parasitología, Universidad de Sevilla, Sevilla, Spain; Biomedal S.L., Sevilla, Spain; Unidad Clínica de Aparato Digestivo, Hospital Universitario Virgen del Rocío, Sevilla, Spain; Celimmune, Bethesda, Maryland, USA; and the Unidad de Gastroenterología y Nutrición, Instituto Hispalense de Pediatría, Sevilla, Spain.
    For their study, the team collected urine samples from 76 healthy subjects and 58 patients with celiac disease subjected to different gluten dietary conditions. To quantify gluten immunogenic peptides in solid-phase extracted urines, the team used a lateral flow test (LFT) with the highly sensitive and specific G12 monoclonal antibody for the most dominant GIPs and an LFT reader. 
    They detected GIPs in concentrated urines from healthy individuals previously subjected to gluten-free diet as early as 4-6 h after single gluten intake, and for 1-2 days afterward. The urine test showed gluten ingestion in about 50% of patients. Biopsy analysis showed that nearly 9 out of 10 celiac patients with no villous atrophy had no detectable GIP in urine, while all patients with quantifiable GIP in urine showed signs of gut damage.
    The ability to use GIP in urine to reveal gluten consumption will likely help lead to new and non-invasive methods for monitoring gluten-free diet compliance. The test is sensitive, specific and simple enough for clinical monitoring of celiac patients, as well as for basic and clinical research applications including drug development.
    Source:
    Gut. 2017 Feb;66(2):250-257.  doi: 10.1136/gutjnl-2015-310148.