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Found 5 results

  1. Celiac.com 08/23/2017 - A team of researchers recently set out to assess how many patients with a diagnosis of non-celiac wheat sensitivity (NCWS) still experienced symptoms of wheat sensitivity after an average follow-up time of 99 months. The research team included Antonio Carroccio, Alberto D’Alcamo, Giuseppe Iacono, Maurizio Soresi, Rosario Iacobucci, Andrea Arini, Girolamo Geraci, Francesca Fayer, Francesca Cavataio, Francesco La Blasca, Ada M. Florena, and Pasquale Mansueto. Using data collected from 200 participants from a previous study of non-celiac wheat sensitivity, performed between July and December 2016 in Italy, the team found that 148 of these individuals still followed a strict wheat-free diet. In total, 175 patients (88%) said that they had fewer symptoms after a diagnosis of non-celiac wheat sensitivity and general improvement. Of the 148 patients who adhered strictly to a gluten-free diet, 145 (98%) had reduced symptoms, compared with 30 of 52 patients who did not adhere to a gluten-free diet (58%) (P < .0001). Of the 22 patients who repeated the double-blind, placebo-controlled challenge, 20 reacted to wheat. The numbers and percentages of the 148 non-celiac wheat sensitivity patients on a strict wheat-free diet who reported that the following symptoms recurred after occasional and accidental wheat consumption: Lack of well-being 135 (91%); Tiredness 102 (69%); Foggy mind 68 (46%); Menstrual alterations 54 (36%); Anemia 46 (31%); Weight increase 45 (30%); Joint/muscle pain 35 (24%); Headache 31 (21%); Weight loss 30 (20%); Anxiety 18 (12%); Skin rash 16 (11%); Recurrent cystitis 12 (8%); Depression 10 (7%). From these numbers, the team concludes that non-celiac wheat sensitivity is a persistent condition. Clinicaltrials.gov registration number: NCT02823522. Source: Gastroenterology. DOI: http://dx.doi.org/10.1053/j.gastro.2017.03.034
  2. Celiac.com 05/24/2017 - Refractory celiac disease (RCD) is a rare manifestation of celiac disease that is difficult to treat, and often results in death from enteropathy-associated T-cell lymphoma. Doctors looking to treat RCD have found very limited success with a number of immunosuppressive medications (IMs), including azathioprine, systemic corticosteroids, or regular budesonide. A team of researchers at the Mayo Clinic recently set out to assess open-capsule budesonide (OB) treatment on RCD patients, including those who saw no improvement with previous IM treatments. The research team included Saurabh S Mukewar, Ayush Sharma, Alberto Rubio-Tapia, Tsung-Teh Wu, Bana Jabri and Joseph A Murray. The team first looked for RCD patients treated with OB at Mayo Clinic, Rochester, Minnesota from 2003 to 2015. They then reviewed demographic, serologic, and clinical variables in these patients. The team found a total of 57 patients who received OB as treatment for suspected RCD. Based on clonal T-cell receptor gamma gene rearrangement or aberrant phenotype of intraepithelial lymphocytes (IELs), the team classified 13 patients (23%) as having RCD-2 and 43 (75%) as RCD-1. The team was unable to determine TCR gene rearrangement status for one patient (2%). Most patients were women (69%), with an average age of 60.5 (+/- 3.5) years, while average body mass index was 28.4 kg/m2. Nearly 75% of patients suffered from diarrhea, with an average of 6 bowel movements per day (range, 4–25). Nearly half of these patients failed to improve with IM treatment. Twenty-four patients (42%) were anemic, while 12 patients (21%) had hypoalbuminemia. Biopsies showed Marsh 3 lesions in all patients, broken down as follows: 19% were Marsh 3a, 46% were Marsh 3b, and 35% were Marsh 3c. After OB therapy, 92% showed clinical improvement, while 89% showed histologic improvement. Subsequent biopsies showed that 7 out of 13 patients with RCD-2 (53%) displayed an absence of the previously observed clonal TCR gamma gene rearrangement/aberrant IEL phenotype. During the follow-up period, two patients died of enteropathy-associated T-cell lymphoma. Most RCD patients show clinical and histopathologic improvement with OB treatment, including those who previously failed to respond to other IMs. These results show that treatment with open-capsule budesonide is a promising option for patients looking to manage RCD. Source: The American Journal of Gastroenterology, (21 March 2017). doi:10.1038/ajg.2017.71
  3. Non-celiac wheat sensitivity (NCWS) is a newly described clinical condition marked by symptoms which may affect the gastrointestinal tract, the nervous system, the skin, and other organs. There is little data regarding the origins of NCWS, and it is likely that numerous factors influence the various clinical manifestations of the condition. The one common thread in NCWS is wheat consumption. Symptoms disappear when wheat is eliminated from the diet, and reappear when wheat is consumed. Looking into the possibility that their NCWS patients might in fact be suffering from non-immunoglobulin E (IgE)-mediated wheat allergy, a team of researchers conducted a review their own earlier data regarding NCWS, with a corresponding review of relevant medical literature on NCWS. The research team included Antonio Carroccio, Pasquale Mansueto, Alberto D'Alcamo and Giuseppe Iacono. Together, they reviewed data on 276 patients diagnosed with NCWS by means of double-blind placebo-controlled (DBPC) wheat challenge. They then examined data indicating a possible wheat allergy diagnosis, and reviewed other study data, along with the role of serum immunoglobulin G antibodies and the basophil activation assay in food allergy, and the histology findings in the food allergy diagnosis. By comparing patients with NCWS and irritable bowel syndrome (IBS) against controls with non-IBS-related NCWS, the team determined that NCWS was marked by: food allergy in the pediatric age (0.01); coexistent atopic diseases (0.0001); positive serum anti-gliadin (0.0001) and anti-betalactoglobulin (0.001) antibodies; positive cytofluorimetric assay revealing in vitro basophil activation by food antigens (0.0001); and a presence of eosinophils in the intestinal mucosa biopsies (0.0001). Patients with NCWS and multiple food sensitivity show several clinical, laboratory, and histological characteristics that suggest they might actually be suffering from non-IgE-mediated food allergy. This is potentially very interesting news regarding NCWS, but the team does note that other pathogenic possibilities need to be considered and investigated before this can be confirmed. Source: The American Journal of Gastroenterology, 5 November 2013. doi:10.1038/ajg.2013.353
  4. Celiac.com 04/20/2009 - Faced with cases of idiopathic dilated cardiomyopathy that seemed to coincide with celiac disease, a team of Turkish researchers recently set out to determine if a possible connection exists between the two conditions. The team was made up of Tugcin B. Polat, Nafiye Urganci, Yalim Yalcin, Cenap Zeybek, Celal Akdeniz, Abdullah Erdem, Elnur Imanov, and Ahmet Celebi, affiliated with the Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Hospital, and/or with the Clinic of Pediatrics, Sisli Etfal Hospital, Istanbul, Turkey. To date, little has been studied about cardiac function specifically as it relates to celiac disease. The researchers undertook their study to assess cardiac functions using Tissue Doppler Echocardiography in patients with celiac disease. The team evaluated 45 clinically stable patients. the time of echocardiographic evaluation, 25 patients showed positive serum IgA Antiendomysial Antibody levels (Group 1), 20 patients showed negative serum IgA Antiendomysial Antibody levels (Group 2). 30 healthy, disease-free children served as a control group. Group 1 showed substantially lower myocardial systolic wave velocity of the mitral annulus (p < 0.001), while Group 2 showed slightly longer myocardial precontraction and contraction times compared to controls (p = 0.015, p = 0.044, respectively). Researchers noted a negative association between the serum IgA Antiendomysial Antibody levels and myocardial systolic wave levels for all subjects (r =−0.633; p < 0.001). A myocardial systolic wave velocity of <8.9 cm/s showed 92% sensitivity and 80% specificity in anticipating patients with positive serum IgA Anti-endomysial Antibody levels. The team concluded that children with celiac disease coupled with prominent serum IgA Anti-endomysial antibody reactivity, show higher rates of subclinical systolic dysfunction of the left ventricle. They also noted that Tissue Doppler echocardiography offers a helpful quantifiable indicator for cardiac monitoring of disease during follow up. Digestive and Liver Disease 40 (2008) 182–187
  5. Vijay Kumar, M.D., Research Associate Professor at the University of Buffalo and President and Director of IMMCO Diagnostics: Not really. It is not true that the serological methods have lower predictive value in children less than two years of age. In all the studies that we did, there was 100% correlation of the EMA to the disease activity irrespective of the age. Karoly Horvath, M.D., Ph.D., Associate Professor of Pediatrics; Director, Peds GI & Nutrition Laboratory; University of Maryland at Baltimore: There are age dependent changes in several blood parameters during childhood. It is well known that immunoglobulin levels depend on the age of children. E.g. the IgA class immunoglobulins reach the adult level only by 16 years of age, and the blood level of IgA immunoglobulins is only 1/5th of adult value below two years of age. A large study from Europe (Brgin-Wollf et al. Arch Dis Child 1991;66:941-947) showed that the endomysium antibody test is less specific and sensitive in children below two years of age. They found that the sensitivity of the EmA test decreased from 98% to 88% in children younger than 2 years of age. It means that 12% of their patients with celiac disease, who were younger than two years of age, did not have an increase in their endomysium antibody levels.
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