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Found 6 results

  1. Celiac.com 01/19/2017 - A team of researchers recently set out to validate the celiac disease diagnoses recorded in the Danish National Patient Register. The research team included Stine Dydensborg, Dydensborg Sander, Ketil Størdal, Tine Plato Hansen, Anne-Marie Nybo Andersen, Joseph A Murray, Søren Thue Lillevang, and Steffen Husby. They are variously affiliated with the Hans Christian Andersen Children’s Hospital, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense Patient Data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark; Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Department of Pediatrics, Ostfold Hospital Trust, Fredrikstad, Norway; Department of Pathology, Hvidovre Hospital, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA; Department of Clinical Immunology, Odense University Hospital, Odense, Denmark. To validate the diagnoses, they used information on duodenal biopsies from a national register of pathology reports (the Patobank) and information on celiac disease-specific antibodies and human leukocyte antigen (HLA) genotypes obtained from patient medical records. Their study included all children born from 1995 to 2012 and registered as having celiac disease in the Danish National Patient Register. They reviewed all pathology reports on duodenal biopsies in the Patobank, along with medical record information on celiac disease-specific antibodies, such as anti-tissue transglutaminase 2 IgA and IgG, endomysial antibodies IgA, and anti-deamidated gliadin peptide IgG) and HLA genotypes. In the Danish National Patient Register, they found 2,247 children with celiac disease. Duodenal biopsies for 1,555 of the children (69%) were registered in the Patobank; 1,127 (50%) had biopsies consistent with celiac disease; i.e., Marsh 2–3. The team accessed the medical records of 95% of the children registered in the ­Danish National Patient Register with celiac disease. They found that 1,510 patients, or 67%, had one or more positive antibody-test results; 1,120, or 50% had anti-tissue transglutaminase 2 IgA ten times or more above the upper limit of the normal range and/or positive endomysial antibody results. The positive predictive value depended on the criteria used for validation and the types and numbers of registrations included in the analysis. Accordingly, the values ranged from 62% (95% confidence interval: 60%–64%) to 86% (95% confidence interval: 84%–87%). These findings indicate that the Danish National Patient Register is a valuable source to identify patients who have been diagnosed with celiac disease. However, they recommend that researchers validate and document diagnoses before using patient data for research purposes. Source: DovePress.com.
  2. Celiac.com 05/24/2016 - People with type II refractory celiac disease (RCD), suffer from severe malabsorption syndrome and face a poor prognosis, as there is currently no effective treatment. Prompted by the regenerative and immune-influencing properties of mesenchymal stem cells (MSCs), a research team recently set out to assess the viability, safety, and efficacy of a series of infusions of autologous bone marrow-derived MSCs in a 51-year-old woman with type II RCD. The research team included R Ciccocioppo, A Gallia, MA Avanzini, E Betti, C Picone, A Vanoli, C Paganini, F Biagi, R Maccario, and GR Corazza. They are variously affiliated with the Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, the Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, the Cell Factory and Research Laboratory, Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, the Clinic Cytometry Laboratory, Department of Hematology, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, Department of Molecular Medicine, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, all in Pavia, Italy. The team began by isolating, expanding, and characterizing mesenchymal stem cells using standard clinical protocols. For each patient, the team arranged to monitor malabsorption indexes, mucosal architecture, and percentage of aberrant intraepithelial lymphocytes at the time of enrollment, at each infusion, and after 6 months. The also arranged to assess mucosal expression of interleukin (IL)-15 and its receptor. Once the team determined that the expansion of MSCs was feasible, they provided the patient with four systemic infusions of 2 × 106 MSCs per kg body weight 4 months apart, with no adverse effects. Over the course of the treatment, the patient experienced gradual and durable improvement of her condition, including normalized stool frequency, body mass index, laboratory test results, and mucosal architecture. Most impressively, the expression of IL-15 and its receptor almost completely vanished. Based on this clinical case, treatment of RCD with serial MSC infusions seems to offer a path to recovery from this life-threatening condition, while blocking the IL-15 pathogenic pathway. This is the first successful treatment of refractory celiac disease. Stay tuned for further developments regarding the use of stem cell infusions to treat refractory celiac disease. Source: Mayo Clin Proc. 2016 Apr 14. pii: S0025-6196(16)30004-0. doi: 10.1016/j.mayocp.2016.03.001.
  3. Celiac.com 05/20/2016 - The Celiac Disease Foundation (CDF) has received an award from the Patient-Centered Outcomes Research Institute (PCORI). The PCORI Eugene Washington Engagement Award will help the CDF to create a national network of advocates trained in patient-centered outcomes research (PCOR), known as the Patient Engagement Celiac Disease Network (PECDN). The project is aimed at patients and caregivers who may be eager to participate in research, but who may feel unprepared to work with researchers, as researcher expectations and terminology can be confusing. Through this network, CDF will train patients and caregivers to become more involved in research in ways that will impact the treatment of their disease. The first training program for patients and caregivers will be offered at Celiac Disease Foundation's National Conference April 30, 2016. Read more at: Bezinga.com
  4. Celiac.com 09/29/2014 - Can a gluten-free diet lead to dramatic improvement of Parkinsonian symptoms in patients with celiac disease? In the January issue of the the Journal of Neurology, researchers Vincenzo Di Lazzaro, Fioravante Capone, Giovanni Cammarota, Daniela Di Giuda, and Federico Ranieri report on the case of a man who saw a dramatic improvement of Parkinsonian symptoms after gluten-free diet. The researchers are affiliated with the Department of Neurosciences at the Institute of Neurology, Campus Bio-Medico University in Rome, Italy. This case is interesting because it supports a growing body of research that indicates that, in some cases, gluten toxicity might adversely impact the nervous system, producing symptoms identical to classical Parkinson’s disease. The man in question was a 75-year-old Parkinson’s disease patient with silent celiac disease saw major improvements in his symptoms after a 3-month long gluten-free diet. Noting the positive results in this patient, and the fact that celiac disease often manifests with only neurological symptoms, even in older patients, the researchers are calling for a deeper exploration to determine if there are higher rates of celiac disease in people afflicted with Parkinson’s disease, or the related multi-factorial neurodegenerative condition known as Parkinsonism. Source: J Neurol. 2014 Feb;261(2):443-5. doi: 10.1007/s00415-014-7245-7. Epub 2014 Jan 25.
  5. Celiac.com 09/15/2010 - Until the present study, no clinical research had been published regarding the relative effects of clinical and psychosocial variables on outcome in celiac disease. A team of researchers examined psychosocial factors that may influence disease activity in celiac patients, such as relationships among demographics, psychosocial factors, and disease activity with health-related quality of life (HRQOL), health care utilization, and symptoms. The research team included Spencer D. Dorn, Lincoln Hernandez, Maria T. Minaya, Carolyn B. Morris, Yuming Hu, Suzanne Lewis, Jane Leserman, Shrikant I. Bangdiwala, Peter H. R. Green and Douglas A. Drossman of the Center for Functional GI and Motility Disorders at the University of North Carolina, Chapel Hill, USA. The team enrolled 101 adult patients with celiac disease with the goal of charting any relationships among demographics, psychosocial factors, and disease activity with health-related quality of life (HRQOL), health care utilization, and symptoms. All patients were newly referred to a tertiary care center with biopsy-proven celiac disease. The team examined: (a) demographic factors and diet status; ( disease measures (Marsh score, tissue transglutaminase antibody (tTG) level, weight change and additional blood studies); and © Psychosocial status (psychological distress, life stress, abuse history, and coping). They then conducted multivariate analyses to predict HRQOL, daily function, self-reported health, number of physician visits, and GI symptoms, such as pain and diarrhea. They found that patients with psychological distress and poor coping skills suffered from impaired HRQOL and daily function. Patients who reported poorer health generally showed poorer coping, longer symptom duration, lower education, and greater weight loss. Patients with poorer coping, abnormal tTG levels, and milder Marsh classification generally had more physician visits. Patients with higher psychological distress and greater weight loss also showed higher pain scores. Patients with greater psychological distress and poorer coping also showed higher rates of diarrhea. Their results show that among patients at celiac disease referral centers, psychosocial factors have a greater impact on health status and GI symptoms than does disease activity. Such factors should be considered as part of the patient's treatment and prognosis. Source: Dig Dis Sci. 2010 Jul 30. DOI: 10.1007/s10620-010-1342-y
  6. Celiac.com 04/13/2010 - A team of clinicians recently described a case of immune modulation by non-Hodgkin lymphoma in a patient with two primary intestinal T-Cell lymphomas and long-standing celiac disease. F. Mühr-Wilkenshoff, M. Friedrich, H. D. Foss, M. Hummel, M. Zeitz, and S. Daum made up the research team. They are variously affiliated with the Medical Clinic I, Gastroenterology, Rheumatology and Infectious Diseases, and with the Department of Pathology, Charité of the Campus Benjamin Franklin of University Medicine Berlin, Germany. About 20–30% of all non-Hodgkin lymphomas (NHLs) are gastrointestinal in nature. Of these gastrointestinal lymphomas, about 20–30% occur in small intestine The clinical team recently reported the case of a 72-year-old patient who had been diagnosed with celiac disease when he was 52-years old. The man had not followed a gluten-free diet, yet showed no evidence of enteropathy or celiac-associated antibodies, but still developed a jejunal T-cell lymphoma. Doctors resected the lymphoma due to perforation and treated the patient with four courses of IMVP-16. The patient began and maintained a strict gluten-free diet. Two years later, the patient appeared with weight loss and a clonally divergent refractory sprue type II with loss of antigen (CD8; T-cell receptor-) expression in intraepithelial lymphocytes. At this time, he showed high titers of celiac-associated antibodies, although he was on a strict GFD. The research team notes that the missing enteropathy under a gluten-containing diet supports the idea of immune suppression in malignant diseases, especially non-Hodgkin lymphoma. They also note that the fact that, even while maintaining a strict gluten-free diet, the patient developed refractory sprue type II, an early form of another independent T-cell lymphoma, along with celiac-associated antibodies, suggests that clonal intraepithelial lymphocytes might be stimulating antibody production. Thus, they conclude that isolated detection of celiac-associated antibodies in patients with celiac disease does not prove that patients have deviated from their gluten-free diets. Source: Digestion 2010;81:231–234 DOI: 10.1159/000269810
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