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Showing results for tags 'gluten-sensitive'.
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A New Study Looks at Celiac Disease and Thrombotic Events
Jefferson Adams posted an article in Latest Research
Celiac.com 10/24/2022 - The advisability of considering the extra-intestinal manifestations of celiac disease, even in patients without typical intestinal symptoms, is not well studied. A team of researchers recently set out to examine the literature regarding the occurrence of thrombotic events in celiac disease, and to synthesize the data from case reports and case series. The research team included Nikola Pantic, Ivana Pantic, Dorde Jevtic, Vanajakshi Mogulla, Stevan Oluic, Momcilo Durdevic, Terri Nordin, Mladen Jecmenica, Tamara Milovanovic,Tatjana Gavrancic, and Igor Dumic. The team performed a systematic review of medical literature by searching the Pub-Med/MEDLINE database through January 2022, to identify published cases and case series on this topic, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The team included a total of 55 cases in the study. Most patients were previously healthy people, with no comorbidities. In nearly one-third of the cases, a celiac disease diagnosis was made before thrombosis began. In just over one-third of the other patients, thrombosis preceded the celiac diagnosis or was made together with the celiac diagnosis. Most thrombosis (about 1 in 3 cases) was found in hepatic veins, while thrombosis of cerebral blood vessels, deep venous thrombosis of lower extremities, and pulmonary thromboembolism were less common. Nearly 4 out of 5 cases of thrombosis were restricted to one site only. Nearly 70% of thrombosis patients were treated with anticoagulants, and placed on a gluten-free diet. This study reinforces the importance of considering extra-intestinal manifestations of celiac disease, even in patients without typical intestinal symptoms. The original article belongs to the Special Issue Celiac Disease and Non-celiac Gluten Sensitivity, Extraintestinal-Associated Conditions: Efficacy of a Gluten-Free Diet. Read more at MDPI.com The researchers are variously affiliated with the Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Serbia; the Clinic of Gastroenterology and Hepatology, University Clinical Center of Serbia, Belgrade, Serbia; the Elmhurst Hospital Center, Department of Internal Medicine, Elmhurst, NY, USA; the Icahn School of Medicine at Mount Sinai, New York, NY, USA; the Mayo Clinic Alix School of Medicine, Rochester, MN, USA; the Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI, USA; the Department of Internal Medicine, Loyola University Medical Center, Maywood, IL, USA; the Department of Hospital Medicine, Advocate Aurora Health, Green Bay, WI, USA; the Oceana Gastroenterology Associated, Corona, CA, USA; and the Department of Hospital Medicine, Mayo Clinic, Jacksonville, FL, USA. -
Celiac.com 08/16/2017 - Colonial Williamsburg prides itself on educating both children and adults in the rich history of life in colonial America. That's why claims that Colonial Williamsburg kicked an 11-year-old boy on a school field trip out of one of its restaurants earlier this year are drawing attention and sharp comment. The incident happened May 11, during a field trip for about 30 students and 30 adults. The trip, which included a meal at Shields Tavern, was the culmination of a yearlong research project. The boy, identified in court documents only as "J.D.," suffers from a medical condition that prevents him from eating the same food as his classmates, and the restaurant's policy specifically forbids outside food. The lawsuit claims that, even after a teacher tried to persuade the manager to let him stay, the manager forced J.D. out of the restaurant, where he ate his lunch in the rain. "J.D. was crying openly as he was removed from Shields Tavern in front of his peers," the lawsuit said. In speaking with management, the teacher learned that the restaurant "permits toddlers to eat outside food, including goldfish and Lunchables inside the restaurant." When J.D. eats gluten, he experiences "precipitous drops in blood pressure that result in him losing consciousness," the lawsuit said. "Doctors haven't determined whether it is celiac disease or a "Non-Celiac Gluten Sensitivity," but multiple specialists at Johns Hopkins have concluded that it is critical J.D. not ingest gluten, even in trace amounts," the suit said. "Before his exclusion, J.D. was able to participate fully with his peers with confidence," the suit said. "After his exclusion and because of Defendant's callous and discriminatory conduct, J.D. felt less worthy than other children and embarrassed by his disability." The family's attorney, Mary Vargas, said in a statement that "Children with disabilities that require strict adherence to special diets often find themselves on the outside of school parties and social events, but here this child was quite literally removed to the outside in a way that left him feeling humiliated and unworthy." She goes on to call the actions by Williamsburg's management "…despicable behavior by any adult but especially by an organization that professes to offer educational programming for children." The lawsuit seeks unspecified damages and attorney fees, as well as changes to how Colonial Williamsburg handles people with disabilities. The Colonial Williamsburg foundation has declined to comment on the suit. Source: pilotonline.com -
Celiac.com 10/07/2013 - People with non-celiac gluten-sensitivity often report gut and non-gut symptoms shortly after eating gluten; symptoms disappear on gluten-free diets, although these patients have no serologic markers of celiac disease, and no intestinal damage. However, there is no evidence to suggest any changes to blood or mucosa in those individuals. To better understand non-celiac gluten sensitivity, a research team recently assessed immunologic responses of duodenal mucosa samples and peripheral blood basophils, isolated from NCGS patients, after exposure to gliadin. The research team included Cristina Bucci, Fabiana Zingone, Ilaria Russo, Ivonne Morra, Raffaella Tortora, Norberto Pogna, Giulia Scalia, Paola Iovino, and Carolina Ciacci. They are affiliated with CEINGE in Naples, Italy; the Consiglio per la Ricerca e la Sperimentazione in Agricoltura in Rome, Italy; the Gastrointestinal Unit of the Department of Medicine and Surgery at the University of Salerno in Salerno, Italy; and with the Gastrointestinal Unit at the Department of Clinical and Experimental Medicine of Federico II University of Naples. Between January 2010 and July 2011, the research team gathered mucosa samples from 34 celiac disease patients who followed gluten-free diets for at least 6 months, 35 patients with untreated celiac disease, 16 patients with non-celiac gluten sensitivity (NCGS) and 34 healthy control subjects. The team diagnosed non-celiac gluten sensitivity based on patient symptoms and current diagnositic guidelines. For each of the 119 patients, the team conducted a complete clinical evaluation to exclude celiac disease while on a gluten-containing diet, a skin prick test to exclude wheat allergy, and upper endoscopy at 2 tertiary medical centers in Italy. After incubating each biopsy sample with gliadin, the team measured inflammatory markers, including anti-phosphotyrosine-monoclonal antibody (PY99), HLA-DR, intercellular cell adhesion molecule-1 (ICAM-1), CD3, CD25 and CD69. After incubation with gliadin, mucosa samples from the 69 patients with celiac disease showed increased immunofluorescence intensity for early and delayed markers of inflammation. They also found low levels of some of these markers in three patients with non-celiac gluten sensitivity and three controls. The team found normal mucosal architecture in 56.3% of patients with non-celiac gluten sensitivity. The remaining seven patients showed increased intraepithelial infiltration, but without eosinophils. They found no villous atrophy in patients with non-celiac gluten sensitivity, and no significant increases in the levels of CD63 and CD203c. The team did find that one patient each in the NCGS and control groups, whose results indicated only weak PY99 and ICAM-1 positivity, also had Helicobacter pylori infection. Unlike mucosa from patients with celiac disease, once incubated with gliadin, mucosa from patients with NCGS does not express markers of inflammation, nor does the gliadin activate their basophils. The in vitro gliadin challenge therefore should not be used to diagnose NCGS. This study does suggest that wheat components, other than proteins, might be associated with GI symptoms in patients with IBS, and should be assessed for a possible role in the pathogenesis of NCGS. Source: Clinical Gastroenterology and Hepatology. Volume 11, Issue 10 , Pages 1294-1299.e1, October 2013
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Author: Rensch MJ; Merenich JA; Lieberman M; Long BD; Davis DR; McNally PR. Address: Fitzsimons Army Medical Center, Aurora, Colorado, USA. Source: Ann Intern Med, 124: 6, 1996 Mar 15, 564-7 OBJECTIVE: To determine the prevalence of celiac disease in a cohort of patients with insulin-dependent diabetes mellitus and to describe the clinical characteristics of patients with coexistent disease. DESIGN: Prospective cohort study. SETTING: U.S. Army medical center. PATIENTS: 47 patients with insulin-dependent diabetes mellitus. MEASUREMENTS: Antiendomysial antibody testing was used to screen for celiac disease. The diagnosis of celiac disease required histologic evidence of villous atrophy and crypt hyperplasia and a positive antiendomysial antibody test result. In patients identified as having coexistent disease, complete blood counts, multiphasic biochemical testing, D-xylose absorption testing, and bone mineral density estimates were done. RESULTS: 3 of 47 patients with insulin-dependent diabetes mellitus (6.4%; 95% CI, 1.4% to 17.5%) had positive antiendomysial antibody test results and small-bowel biopsy specimens consistent with celiac disease. The 95% CI lies entirely above the estimated prevalence of celiac disease expected in the general U.S. population, which ranges from 0.02% to 0.1%. Mean bone mineral densities were 0.8 and 1.1 SD below age-, ethnicity-, and sex-matched controls in each of the 2 antiendomysial antibody-positive patients tested. Small bowel absorption was abnormal in 1 of the 2 patients tested by D-xylose. Anemia and hypoalbuminemia were not detected in any of the patients with coexistent disease. Only 1 of the 3 patients had symptoms of diarrhea. All patients were at or above their ideal body weights. CONCLUSIONS: Celiac disease appears to be more common among patients with insulin-dependent diabetes mellitus than in the general U.S. population (p less than 0.001). Two of the three patients with coexistent disease in this study had sub-clinical or latent celiac disease. -
Author: Troncone R; Greco L; Auricchio S Address: Department of Pediatrics, University Federico II, Naples, Italy. Source: Pediatr Clin North Am, 43: 2, 1996 Apr, 355-73 Abstract: Gluten-sensitive enteropathy is induced by dietary wheat gliadin and related proteins in genetically susceptible individuals. Most evidence suggests that the mucosal lesion represents an immunologically mediated injury triggered by gluten in the context of a particular assortment of major histocompatibility complex genes. The amino acid residues of gliadin and related proteins responsible for toxicity have not been identified; in vitro systems are available, but definitive conclusions must rely on in vivo jejunal challenges. At a conservative estimate, symptomatic gluten-sensitive enteropathy affects approximately 1 in 1000 individuals in Europe; however, it is now becoming clear that a greater proportion of individuals has clinically silent disease, and probably many others have a minor form of the the enteropathy. In most countries, the clinical presentation has changed over the past few years coming closer to the adult type of the disease, and the age of onset of symptoms is shifting upward. Liver, joint, hematologic, dental, and neurological symptoms are increasingly being recognized. Several diseases are associated the gluten-sensitive enteropathy, such as IgA deficiency, insulin-dependent diabetes mellitus, and a range of other autoimmune diseases. Tests based on the measurement of antigliadin and antiendomysium antibodies have gained success as noninvasive screening tests; however, the ultimate diagnosis still is based on the finding of a severe histologic lesion of the jejunum while the patient is on a gluten-containing diet and on its disappearance once the gluten is excluded from the diet. A lifelong, strict gluten-free diet is mandatory for celiac children. Among other long-term problems, an increased risk of intestinal lymphoma has been reported in patients on a normal gluten-containing diet.
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