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Found 11 results

  1. Celiac.com 12/03/2018 - Biomarkers in blood samples are not effective indicators for diagnosis or monitoring of celiac disease. A team of researchers recently set out to assess biomarkers of celiac disease derived from neoepitopes of deamidated gliadin peptides (DGP) and tTG fragments, and to assess their usefulness in identifying patients with celiac disease with mucosal healing. The research team included RS Choung, SK Rostamkolaei, JM Ju, EV Marietta, CT Van Dyke, JJ Rajasekaran, V Jayaraman, T Wang, K Bei, KE Rajasekaran, K Krishna, HK Krishnamurthy, and JA Murray. They are variously affiliated with the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA; Vibrant Sciences LLC, San Carlos, CA, USA; and with the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA. The team began by analyzing serum samples from 90 patients with biopsy-proven celiac disease, along with 79 healthy control subjects for immune reactivity against the tTG-DGP complex. They used a fluorescent peptide microarray platform to estimate the antibody binding intensity of each synthesized tTG-DGP epitope. They validated results in 82 patients with newly diagnosed celiac disease, and in 217 control subjects. They assessed the ability of the peptide panel to spot patients with mucosal healing based on histologic results and using serum samples from 85 patients with treated and healed celiac disease; 81 patients with treated but unhealed celiac disease who showed villous atrophy despite adhering to a gluten-free diet; 82 patients with untreated celiac disease; 27 disease control subjects who showed villous atrophy without celiac disease; and 217 healthy control subjects. To assess their data, they relied on principal component analysis followed by machine learning and support vector machine modeling. In all, the team found 172 immunogenic epitopes of the tTG-DGP complex. Compared with control subjects, celiac patients showed substantially higher immune reactivity against these epitopes. In the test group, neoepitopes derived from the tTG-DGP complex identified people with celiac disease with a remarkable 99% sensitivity and 100% specificity. Blood samples from untreated celiac patients showed the greatest average antibody-binding intensity against the tTG-DGP complex. Blood from patients with treated but unhealed CeD mucosa (15.1 ± 7.5) showed significantly higher average antibody-binding intensity than blood from patients with treated and healed CeD mucosa (5.5±3.4) (P<.001). The test spotted celiac patients with healing mucosa with 84% sensitivity and 95% specificity. The research team discovered immunogenic epitopes of the tTG-DGP complex, and found that a test that measures immune response to epitopes accurately identified both celiac patients and patients with mucosal healing. From this study, the team concludes that the biomarker method for celiac testing could be useful in both the detection and monitoring of celiac disease. Read more at: Gastroenterology.
  2. I absolutely adore my gastroenterologist. He is very dedicated to my well being. Unfortunately,I feel that at nearly every appointment that we have he always ends on the note of the possibility of lymphoma. He has a lot of diagnostic appointments for blood work and some barium imaging studies that he has me scheduled for over the next few months that are primarily to r/o cancer. Is this a common fear among celiac patients or should I be concerned? (I am already concerned actually I am just trying to see if this is common practice) Thanks Kortney
  3. Hello world, This is my first time ever posting, so bare with me as I make it through the learning curve. I'm a 26 year old female, with symptoms starting over 10 years ago. It started with terrible pain and nausea eating Tex-Mex. Not gassy pain, but someone is slicing open my stomach and rubbing broken glass around kind of pain. It took me years to figure out it was the avocado in the guacamole. Fast forward 5 years and I start to have the same reaction to eggs. After 5 years of not eating eggs, i'm baffled by the blood test that came back negative for a food allergy. What is causing my body to react that way? I've had preliminary blood work, but the only positive results for celiac was the igG gliadin. Does this indicate anything? igg- 33 (30 is cut off for "normal") iga- 4.5 (5 is cut off) iga 17 (20 is cut off) i think this is the tissue one I'm scheduled for an endoscopy and colonoscopy, but that wont be for a few weeks. More info that may or may not be related. Most of the symptoms have been around a while: Anxiety/depression (mostly severe anxiety) add/mental fog patch of unidentifed "stuff" on my face. (ive always assummed it was a dry patch that comes and goes, but it is very smilar to that of lupus's butterfly skin condition on face) dry burning eyes and need of glasses insomnia (no matter how tired I am) fatigue (no matter how much sleep I get) loss of weight and appetite cold hands and feet (all the time, i can be sweating and they are still icicles) mild fevers milder, constant, lower back and gut pain sometimes pain is sharp in my gut, and i'm finding blood in my stool (this can happen for weeks at a time) sometimes after I eat, I have to go to the bathroom right away. do not pass go, do not collect $200 Mother and sister have autoimmune problem with thyroid and hashimotos, and both grandfathers with colon cancer I was gluten free for 24-48 hours before i realized i needed to keep with it for testing, and i was ravenously hungry and fell asleep before my husband, which could be considered a small miracle. mind over matter, or actuall helpful in such a small time frame. I'm also being tested for lupus, and i'm guessing they'll know If I have an IBD when I get my Scopys done (irritable bowel disease) I can find a lot of my symptoms on a few different diseases/autoimmune lists, so i'm more confused that ever.
  4. Celiac.com 04/02/2012 - A team of researchers recently set out to assess diagnostic yield of Vβ and Vγ clonality in refractory celiac disease (RCD). The team set out to verify whether analyzing both TCRβ and TCRγ clonality in duodenal biopsies from RCD patients improves diagnostic accuracy. The research team included Vittorio Perfetti, Laura Brunetti, Federico Biagi, Rachele Ciccocioppo, Paola I. Bianchi, and Gino R. Corazza. They are affiliated with the Coeliac Centre/First Department of Internal Medicine, and the Department of Medical Oncology at the Fondazione IRCCS Policlinico San Matteo of the University of Pavia in Italy. Refractory celiac disease is what is known as a pre-neoplastic condition, because many patients develop a kind of cancer called enteropathy-type T-cell lymphoma, which is a mature T-cell receptor α-β lymphoma that forms in the gut, and is often fatal. Recent research has been directed at a variety of intraepithelial intestinal lymphocytes. Polymerase chain reaction (PCR) analysis and sequencing shows that these lymphocytes both express the same lymphoma T-cell receptor variable region (V)γ. Also, the Biomedicine and Health-2 Concerted Action has created standardized, highly specific, and sensitive PCR assays for both Vγ and Vβ. The team set out to verify whether analyzing both rearrangements in duodenal biopsies from RCD patients increases the diagnostic accuracy of this method. For the study, the team analyzed duodenal biopsies from 15 RCD patients, 21 negative controls, and 2 positive controls with enteropathy-type T-cell lymphoma complicating celiac disease. The them conducted multiplex clonality analyses using Biomedicine and Health-2 protocols. They cloned and sequenced PCR products. They found monoclonal rearrangements in 5/15 samples from patients with RCD, two of which showed both rearrangements, two which showed Vβ, and just one Vγ clonality. Monoclonality was found in 4/8 of the RCD patients who subsequently died, whereas only 1/7 of the patients still alive presented a monoclonal rearrangement. Positive controls revealed both monoclonal rearrangements; rearrangements were not detected in 20 of 21 negative controls. Sequencing of the amplified fragments confirmed the results. Results showed that the combined analysis of both TCRβ and TCRγ rearrangements allowed recognition of monoclonal populations in patients who otherwise tested negative. Overall detection rates increased from 20%(Vγ only) to 33%(Vγ and Vβ), Increasing detection in patients who would otherwise test negative increases chances of early identification of RCD patients at high risk of death. Source: J Clin Gastroenterol. 2012 Jan 30.
  5. Celiac.com 06/03/2010 - Clinical presentation of celiac disease can vary considerably from patient to patient. Most patients with celiac disease present atypical symptoms. Moreover, most patients who present abdominal symptoms in primary care do not have celiac disease, and so diagnostic tests for celiac disease are not necessary and should be avoided. A team of researchers recently conducted a systematic review of diagnostic testing for celiac disease among patients with abdominal symptoms. The team included Daniëlle A. W. M. van der Windt, PhD; Petra Jellema, PhD; Chris J. Mulder, MD, PhD; C. M. Frank Kneepkens, MD, PhD; and Henriëtte E. van der Horst, MD, PhD. Their article appears in the Journal of the American Medical Association. The goal of the research was to review and summarize evidence on the performance of diagnostic tests for spotting celiac disease in adults who present abdominal symptoms in primary care or similar settings. To obtain initial data, the team search MEDLINE (from January 1966 through December 2009, and EMBASE from January 1947 through December 2009. They also conducted a physical search of references for additional relevant studies. The team chose cohort or nested case-control diagnostic studies which included adults presenting non-acute abdominal symptoms, which featured celiac disease prevalence of 15% or less, and in which the tests included gastrointestinal symptoms or serum antibody screens. Two independent reviewers conducted studies tool and data extraction. They then calculated sensitivities and specificities for each study and computed pooled estimates using bivariate analysis where there was clinical and statistical homogeneity. In all, the team included sixteen studies encompassing 6085 cases in their review. Specificity, sensitivity, and confidence intervals for predicting celiac disease varied with abdominal symptoms. For patients presenting with classic diarrhea, for example, predictive sensitivity ranged from 0.27 to 0.86, while specificity ranged from 0.21 to 0.86. Pool estimates for 8 studies on IgA antiendomysial antibodies were 0.90, with a 95% confidence interval [CI] (0.80-0.95) for sensitivity and 0.99, with a 95% CI (0.98-1.00) for specificity, with a positive likelihood ratio [LR] of 171 and negative LR of 0.11. Pool estimates for IgA antitissue transglutaminase antibodies (7 studies) were 0.89, with a 95% CI (0.82-0.94) and 0.98 at 95% CI (0.95-0.99), respectively, with a positive LR of 37.7 and negative LR of 0.11. IgA and IgG antigliadin antibodies showed variable results, especially for sensitivity, which ranged from 0.46-0.87 for IgA, and from 0.25-0.93 for IgG. One recent study using deamidated gliadin peptides showed good specificity (0.94), but the target population offered limited supporting evidence. For adults who present abdominal symptoms in primary care or other unscreened settings, IgA antitissue transglutaminase antibodies and IgA antiendomysial antibodies offer high sensitivity and specificity for diagnosing celiac disease. SOURCE: JAMA. 2010;303(17):1738-1746. doi:10.1001/jama.2010.549
  6. For immediate release. Please post. Celiac.com 07/13/2010 - Writer, researcher, and celiac advocate, Dr. Ron Hoggan, Ed. D., and long-time celiac advocate Scott Adams, founder and owner of Celiac.com, the largest and longest running website that caters to the gluten-free lifestyle, have joined forces to bring you a new, broad spectrum book about the many facets of gluten-induced illnesses and how to avoid or reverse them. In their new book, Hoggan, Adams, and their 27 co-authors reveal many of the hidden secrets of this widespread, insidious health hazard. This is more than a book about celiac disease and gluten sensitivity. It is a how-to manual for getting a diagnosis, reversing symptoms, improving one’s health, and living well on a gluten-free diet. Cereal Killers: Celiac Disease and Gluten-Free A to Z is a new resource that provides the most diverse exploration of this topic currently available. From the research scientist to the concerned parent, all voices are heard in this novel approach to curing gluten-induced ailments. There is information here for all levels of interest in this burgeoning new area of research and health care. "Hoggan & Adams have brought together a wide range of viewpoints at multiple levels. This book should appeal to a broad spectrum of readers who want a full and enriched perspective." --Robert Machon, July 12, 2010 Newly diagnosed celiac and gluten sensitive patients complain about conflicting information, from the safety of oats to the hazards of older grains. Cereal Killers has the answers to these and many other questions. Even seasoned members of the gluten-free community want a better understanding of their illness and the bounds of a safe diet. These questions are also addressed. Common errors, common misconceptions about the diet, and unusual insights into the dynamics of inflammation, disease, and recovery are all offered by one or more of the many voices that form this unique offering. But the information runs much deeper than that. Cereal Killers explores subtle nuances of immune reactions, often overlooked signs and symptoms of celiac disease, and a host of elements of associated illnesses that miraculously clear up on the diet. Questions about non-celiac gluten sensitivity are addressed in detail, along with explorations of what signs and symptoms should signal testing for gluten sensitivity and how much credence these indicators of disease should be given. In all, readers are offered a rich resource for understanding the importance of dietary compliance along with the cracks in the system through which patients sometimes slip because of current deficiencies in the understanding of gluten sensitivity and celiac disease. Jointly published by CreateSpace, Cereal Killers ISBN: 978-1449918200 is available through Celiac.com, and quality book sellers such as Blackbond Books.
  7. Celiac.com 06/04/2010 - A team of researchers recently set out to assess the positive predictive value of blood test screening for possible cases of celiac disease. The team included Peter Toftedal, Christian Nielsen, Jonas Trolle Madsen, Kjell Titlestad, Steffen Husby, and Søren Thue Lillevang. They are affiliated with the Hans Christian Andersen Children's Hospital, and the Department of Clinical Immunology of Odense University Hospital in Denmark. P. Toftedal and Ch. Nielsen made contributions to the final published article. In deciding which possible celiac disease cases might require duodenal biopsy, doctors rely mainly on tests for celiac disease antibodies, such as immunoglobulin A (IgA) anti-tissue transglutaminase (anti-tTG), IgA endomysium antibody (EMA), IgA and IgG anti-gliadin antibodies (IgA and IgG AGA). For their study, the research team wanted to assess the diagnostic quality of blood testing for possible cases of celiac disease. They did this by performing celiac disease blood tests (IgA and IgG AGA, anti-tTG and EMA) on 11,915 subjects. They then combined the serological data with clinical data and duodenal biopsy results using a unique Danish personal identification number. They found that positive predictive value (PPV) fluctuated in accordance with various combinations of positive celiac disease antibodies. They found the highest predictive value (97.6%) when results for IgA and IgG AGA, anti-tTG and EMA antibodies were all positive. The team used a logistic regression model at initial blood screening to predict the probability of later biopsy-proven celiac disease in relation to concentrations of IgA AGA and anti-tTG. They found that anti-tTG concentrations correlated strongly with EMA positivity, number of additional positive antibodies, and higher PPV. The anti-tTG concentration upon first blood screening for celiac disease was highly informative in relation to EMA positivity, number of additional celiac disease specific antibodies and PPV. Lastly, results for the high-risk patient group showed that anti-tTG and IgA AGA concentrations at initial serological screening accurately predicted probability of future biopsy-proven celiac disease. Source: Clin Chem Lab Med 2010;48:685–91. DOI: 10.1515/CCLM.2010.136
  8. Celiac.com 05/21/2010 - Celiac disease is a genetic, permanent auto-immune disease with a variety of symptoms which, when treated with a gluten-free diet, usually subside. While clinical presentation is variable, most patients that are treated for abdominal pain do not have celiac disease. It is therefore important to accurately diagnose celiac disease in patients exhibiting abdominal pain, without unnecessarily testing patients that do not have celiac disease. Researchers at the Arthritis Research UK National Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire ST5 5 BG, UK, evaluated sixteen studies of patients exhibiting abdominal pain. The occurrence of the abdominal symptoms varied vastly including the varied sensitivity of diarrhea. The IgA and IgG antigliadin antibodies exhibited varying results, particularly for sensitivity. A recent study used diamidated gliadin peptides and showed good specificity, but the results were limited in that specific target population. The conclusive results showed that among adult patients exhibiting abdominal symptoms, “IgA antitissue transglutaminase antibodies and IgA antiendomysial antibodies have high sensitivity and specificity for diagnosing celiac disease”. Source: JAMA. 2010 May 5;303(17):1738-46. Review.
  9. Celiac.com 04/27/2010 - A team of clinicians recently assessed the diagnostic value of confocal endomicroscopy in celiac disease. Clinicians U. Günther, S. Daum, F. Heller, M. Schumann, C. Loddenkemper, M. Grünbaum, M. Zeitz, and C. Bojarski made up the research team. They are variously affiliated with the Medical Clinic of Gastroenterology, Rheumatology and Infectious Diseases, and with the Department of Pathology, Charité of the Campus Benjamin Franklin of University Medicine Berlin, Germany. Studies by Gutschmidt, by Henker and others have shown that, even in the face of greater awareness and more widespread blood testing, a number of countries suffer from low rates of celiac disease detection. Patchiness of the mucosal and submucosal changes associated with celiac disease impedes proper celiac diagnosis, and contributes to a small, but important sampling error among those assessed. Some clinicians feel that the problem might be resolved somewhat by modifying the endoscopic screening process to include real-time assessment of the duodenal morphology. Better endoscopic and imaging procedures will mean better diagnostic accuracy of biopsy specimens. One early step toward improved gathering of targeted biopsies in celiac disease patients lies in using magnification endoscopy, either alone, or together with high-resolution narrow-band imaging. This method offers better ability to detect patchy villous atrophy sites in the duodenum. However, neither magnification, nor narrow-band imaging techniques can detect increased number of intraepithelial lymphocytes (IELs). Confocal endomicroscopy (CEM) permits live, real-time histology with a 1000x magnification during endoscopy. Recently, a prospective pilot study for the first time showed CEM to enable effective live, real-time diagnosis and evaluation of celiac disease. Researchers compared endomicroscopic findings during live, real-time endoscopy with histological findings graded according to Marsh classification. The research team used CEM to examine twenty-four patients with celiac disease and six patients with refractory celiac disease, all following a gluten-free diet. The team evaluated duodenal mucosa by CEM and by conventional histological analysis for villous atrophy, crypt hyperplasia, and increased numbers of intraepithelial lymphocytes (IELs > 40/100 enterocytes). They then compared the CEM to the histology results for sensitivity, specificity, and inter-observer variability using Marsh classification scores. As control subjects, the team used thirty patients without celiac disease, but who were undergoing routine upper gastrointestinal endoscopy. Using conventional histology on the 30 patients with celiac disease, the team found 23 cases with villous atrophy and crypt hyperplasia, and 27 cases of increased IELs. Using CEM, the team found 17 cases of villous atrophy, 12 cases of crypt hyperplasia, and 22 cases of increased IELs. The CEM results compared favorably to those of conventional histology for villous atrophy, for which CEM showed a sensitivity of 74%, and for increased numbers of IELs, for which CEM showed a sensitivity of 81%. However, the CEM results were lacking for detecting crypt hyperplasia, for which CEM showed a sensitivity of 52%. The κ values for determination of inter-observer variability were 0.90 for villous atrophy, 1.00 for crypt hyperplasia, and 0.84 for IEL detection. For the 30 control patients, both traditional histology and CEM revealed normal duodenal architecture with overall specificity of 100%. From these results, the team concluded that the assessment of duodenal histology by CEM in patients with celiac disease is sensitive and specific in determining increased numbers of IELs and villous atrophy, but inadequate for detecting crypt hyperplasia. Until improvements are made, CEM is not suitable for use in diagnosing celiac disease. SOURCE: Endoscopy 2010; 42:197–202.
  10. Celiac.com 03/25/2010 - A team of researchers recently set out to compare the diagnostic performance of IgG anti-deamidated gliadin peptide antibody assays against IgA anti-tTG in celiac disease. The team included P. Vermeersch, K. Geboes, G. Mariën, I. Hoffman, M. Hiele, X. Bossuyt, all associated with the department of Laboratory Medicine, Immunology of University Hospitals at the Catholic University of Leuven, Belgium. Using IgG anti-deamidated gliadin peptide antibody assays to test for celiac disease is more sensitive and more specific for celiac disease than detection of IgG antibodies against native gliadin. The team compared assessed the technical performance and accuracy (sensitivity and specificity) of commercial IgG anti-DGP assays from Euroimmun, Inova, Phadia and The Binding Site against other serologic assays for celiac disease, such as 3IgA and 2IgG anti-tTG assays, 1IgA and 1IgG anti-gliadin assay, 1IgA anti-DGP assay. For the study, they tested 86 patients with clinically proven celiac disease and 741 healthy control subjects. Technical performance of IgG anti-DGP assays as gauged by linearity, interference and imprecision, was within acceptable levels. IgG anti-DGP assay sensitivity ranged between 76.7% and 83.7% at the manufacturer's recommended cut-off, and between 74.4% and 84.9% at a cut-off that corresponded to a 98% specificity level. Specificity ranged between 97.3% and 99.3%. The diagnostic accuracy of the IgG anti-DGP assays was comparable to the diagnostic accuracy of the IgA anti-tTG assays. IgG anti-DGP assays showed significantly better than sensitivity than the IgG anti-tTG assays (p<0.05) and and significantly better specificity than IgA and IgG anti-gliadin assays (p<0.05). The four IgG anti-DGP assays all performed within acceptable limits, and diagnosed celiac disease with comparable accuracy as did the three IgA anti-tTG assays. Source: Clin Chim Acta. 2010 Feb 19.
  11. TI- Disaccharidasen-Aktivitaten als Beurteilungskriterium der Dunndarmschleimhaut. AU- Stern M; Plettner C JN- Monatsschr Kinderheilkd; 131 (5) p264-8 PY- May 1983 AB- Activities of lactase, sucrase, and maltase were determined in small intestinal biopsies of 125 children with Coeliac disease, cows milk protein intolerance, transient gluten intolerance, nonspecific enteropathies, and controls. Four cases of primary disaccharidase deficiencies could be identified. In the enteropathies, morphometric data were more closely correlated to the degree of the mucosal lesion (r = -0.92 for crypt depth) than were disaccharidase activities (r = 0.61 for lactase). In a stepwise discriminate analysis of the patient groups, based upon immunological, morphometric, and biochemical variables, lactase activity was a valuable secondary criterion, ranking third among the variables used.
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