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Showing results for tags 'eosinophilia'.
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Hello, I have continued to be vigilant in my gluten free diet; sticking with mostly whole foods with the exception of peanut butter, oikos yogurt, larabar's and the very seldom certified gluten free chip/cracker when I just want to have something that makes me feel "normal". I was doing quite well up until the end of February, when I started to have fatigue, brain fog, Diarrhea, severe daily continuous headaches, congestion mostly at night, sneezing often mostly at night, itchy top of mouth and rash that started on both hands. Later, the rash started to appear on my neck and left side rib area. I saw my GI and got some labs drawn. Celiac antibodies all trending down appropriately for the amount of time I have been gluten free. CBC and CMP looked fine. I figured I had been glutened and that the symptoms would go away. The symptoms persisted and I kept looking into my diet to eliminate any possible gluten exposure. I decided to get rid of a seasoning I had purchased that was labeled "gluten free" and my headaches went away but the other symptoms persisted. Symptoms continued with the addition of Nausea that began after I would eat and would persist for about 1 to 2 hours after. I wouldn't ever vomit but just felt "ill" whenever I would. The rash on my hands, neck and left ribs continued to be flared up. I again reached out to my GI doctor due to the continued symptoms and new symptoms. They ordered repeat CBC and CMP, CRP, Stool culture, Calprotectin (stool), and Stool GI panel. all of the stool studies came back negative for infection/parasites/inflammation. However, on my CBC, now I had significant Eosinophilia that was not present just over a month before. My eosinophils rose from 4% up to 28% and my GI referred me to an Allergist/dermatologist for further testing. I had a scoop biopsy from directly on some of the bumps/pustules on one of my fingers and then they took a punch biopsy from unaffected skin on my forearm (not near any lesions). I'm still waiting to hear back on the biopsy results for these. However, I was put on a 1 week medrol dose pack by my GI to help calm my system down and while I was on the steroid the rash slightly improved but the day after I completed the steroids, the rash flared right back up and actually was worse than before. Now, the rash continues to worsen and involves the entire tops of both hands and on all of my fingers. the neck rash and torso rash went away with steroids and haven't come back since. I have been using triamcinolone cream on my hands and it doesn't seem to be helping. The rash is extremely itchy, with burning and I am developing large cracks on my fingers with thickening skin. The cracking is painful. I saw the allergist and had scratch testing done. I reacted to pretty much every environmental allergen tested and reacted to many foods that they tested for. I reacted on the skin test to peanuts, watermelon, cucumber, walnuts, pecans, pistachios, hazelnuts, dairy, and almonds. The allergist then sent me for blood work testing for total IgE and specific food IgE to what I reacted to on skin test. I came back with Class 4 "very high" specific IgE levels for pistachio, almond, dairy, walnuts, peanuts, hazelnuts, and pecans. My total IgE came back 8,800 kU/L (standard range less than 214 kU/L). I'm still waiting to hear back from allergist regarding these results. It appears that my body is mounting a huge immune response and maybe a lot of the on-going symptoms I am having are related to possibly new food allergies. Does this sound like a gut permeability issue leading to new allergies, related to my Celiac disease? Also, important to note, the allergist specifically ordered a serum histamine level to assess for mast cell activation syndrome and my histamine was high normal at 8 (standard range 0-8). She also checked a rheumatoid factor and ANA which both came back normal. My allergist said she thinks I am just extremely Atopic and she wants to wait until the biopsy results come back for the rash to make any further plans. She mentioned wanting to put me on a biologic (dupixent) depending on whether the rash is atopic dermatitis....I have no idea about any of that though... She also wants to discuss putting me on allergy shots tailored to my specific allergens. Allergist mentioned wanting to check for EoE as well at some point because I have been having issues with food getting caught in the back of my throat and having trouble getting it to clear when it happens.. I have an EGD tentatively scheduled for October as my GI wanted to go in and look after 1 year gluten free. She actually mentioned she may want to do the EGD sooner if my symptoms persist and at that point EoE could be assessed. I was going to be checked for SIBO on May 7th but a part on the machine broke and they had to cancel it until it can be fixed. Does Leaky gut related to Celiac disease cause full blown IgE mediated allergies to develop or is it generally more of just food intolerances that develop from leaky gut? It appears my re-occurring/on-going symptoms may be indirectly related to my Celiac disease, by way of new food allergies but not specifically by getting glutened like I originally thought I was. Anyone experience something similar? It feels like I'm on the right track to getting things figured out. Any thoughts or suggestions would be appreciated!
- 29 replies
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- allergies
- eosinophilia
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Celiac.com 03/23/2022 - There's not much solid data, and no clear consensus, on the connection between eosinophilic esophagitis and celiac disease. There seems to be no clear pattern to the conditions in which they occur together in patients. A team of researchers recently set out to investigate rates of esophageal eosinophilia and eosinophilic esophagitis in a large group of children with celiac disease, and to prospectively follow the group over an eleven year period. The research team included Fernanda Cristofori; Fulvio Salvatore D’Abramo; Vincenzo Rutigliano; Vanessa Nadia Dargenio; Stefania Castellaneta; Domenico Piscitelli; Davide De Benedittis; Flavia Indrio; Lidia Celeste Raguseo; Michele Barone; and Ruggiero Francavilla. They are variously affiliated with the Interdisciplinary Department of Medicine, Pediatric Section “B. Trambusti”, University of Bari “Aldo Moro” in Bari, Italy; the Department of Emergency and Organ Transplantation, Section of Gastroenterology, University of Bari “Aldo Moro” in Bari, Italy; the Department of Emergency and Organ Transplantation, Section of Pathology, University of Bari “Aldo Moro” in Bari, Italy; the Department of Information Engineering, University of Pisa, Largo L. Lazzarino in Pisa, Italy; and the Department of Medical and Surgical Science, University of Foggia, Viale L. Pinto, 71122 Foggia, Italy. The team used data from a prospective observational study performed between 2008 and 2019. They used ESPGHAN criteria to make celiac disease diagnosis. They sampled at least four esophageal biopsies in patients who underwent endoscopy. The team defined esophageal eosinophilia as at least 15 eosinophils/HPF seen on esophageal biopsy. They diagnosed eosinophilic esophagitis using the International Consensus Diagnostic Criteria for Eosinophilic Esophagitis. The team diagnosed a total of 465 children with celiac disease. A total of three hundred and seventy patients underwent endoscopy, while the team found esophageal biopsies for 313 of those. The rate of esophageal eosinophilia in children with celiac disease was 1.6%. Just a single child was diagnosed with eosinophilic esophagitis, for which the team calculated a prevalence rate of 0.3%. Overall, the team saw eosinophilic esophagitis in celiac patients at a rate at least 6.5 times higher than in the general population. According to the team, eosinophils over 15/HPF do not have a clinical implication or warrant intervention in celiac patients, so they do not recommend esophageal biopsies beyond what may be clinically indicated. This is one of the first studies to put some hard numbers on the connection between eosinophilic esophagitis and celiac disease. The idea that people with celiac disease don't generally need to worry about eosinophilic esophagitis is one less thing to deal with in the often confusing world of living with celiac disease. Read more: Nutrients 2021, 13(11), 3755
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- celiac disease
- eosinophilia
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Celiac.com 06/14/2017 - Some data have suggested a connection between celiac disease and eosinophilic oesophagitis (EoE)/oesophageal eosinophilia (EE). Any potential relationship has implications for treatment. Should the two conditions be treated together, or separately? To better understand any possible connection, and the implications for treatment, a team of researchers recently set out to characterize children with celiac disease+EE in-depth and assess the contribution of each condition to the clinical presentation and treatment response. The research team included Anne Ari, Sara Morgenstern, Gabriel Chodick, Manar Matar, Ari Silbermintz, Amit Assa, Yael Mozer-Glassberg, Firas Rinawi, Vered Nachmias-Friedler, Raanan Shamir, and Noam Zevit. They are variously affiliated with the Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children’s Medical Center of Israel, Petach Tikvah, Israel, the Pediatrics Center at Schneider Children’s Medical Center of Israel, Petach Tikvah, Israel, the department of Pathology at Rabin Medical Center in Petach Tikvah, Israel, and the Sackler Faculty of Medicine at Tel Aviv University in Tel Aviv, Israel. The research team conducted a retrospective review of medical records of children with both celiac disease+EE, or isolated EoE diagnosed between 2000 and 2014. They then compared these records with those of patients with isolated celiac disease or epigastric pain. To calculate the frequency of EE, they used endoscopy results of patients with suspected celiac disease or epigastric pain between 2011 and 2014. They used a telephone questionnaire to gather missing data. At a single large, tertiary pediatric center, the team assessed 17 patients with celiac disease+EE, 46 with EoE, 302 with isolated celiac disease, and 247 with epigastric pain. The patients with celiac disease+EE shared characteristics of both individual conditions. While age at diagnosis, family history of autoimmunity/celiac disease and anaemia were similar to most celiac patients, other characteristics such as male gender, personal/family history of atopy, peripheral eosinophilia and oesophageal white papules more closely resembled those of patients with EoE. Most patients with celiac disease+EE tended to present with celiac-associated symptoms, and 63% went on to develop typical EoE symptoms. In celiac disease+EE patients, only 21% saw their EE resolve after a gluten-free diet; another 21% saw their EE normalize after proton pump inhibitor treatment. The rest required EoE-specific treatment. Patients with celiac disease found to have EE share characteristics similar to both isolated celiac disease and EoE. This study indicates that celiac patients with concurrent EE are actually suffering from two separate conditions, rather than celiac-associated eosinophilia. Therefore, in such patients, doctors should consider treating each condition separately. Source: Archives of Disease in Childhood Published Online First: 12 April 2017. doi: 10.1136/archdischild-2016-311944
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