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Found 46 results

  1. Celiac.com 11/06/2018 - Autoimmune pancreatitis is a rare disorder whose association with celiac disease (celiac disease) has never been investigated, although celiac patients show high rates of both endocrine and exocrine pancreatic affections. To address this lack of information, a team of researchers recently set out to evaluate the frequency of celiac disease in patients with autoimmune pancreatitis and in further medical pancreatic disorders. The research team included G De Marchi, G Zanoni, MC Conti Bellocchi, E Betti, M Brentegani, P Capelli, V Zuliani, L Frulloni, C Klersy, and R Ciccocioppo. They are variously affiliated with the Department of Medicine, the Department of Pathology and Diagnostics, the Gastroenterology Unit, the Immunology Unit, and the Pathology Unit of the Department of Pathology and Diagnostics; and the Gastroenterology Unit of the Department of Medicine, AOUI Policlinico G.B. Rossi, University of Verona in Verona, Italy; the Clinica Medica I, Department of Internal Medicine, IRCCS Policlinico San Matteo Foundation in Pavia, Italy; and the Clinical Epidemiology & Biometry Unit, IRCCS Fondazione Policlinico San Matteo; Pavia, Italy. They screened for celiac disease by looking for tissue transglutaminase (tTG) autoantibodies in the blood of patients retrospectively enrolled and divided in four groups: autoimmune pancreatitis, chronic pancreatitis, chronic asymptomatic pancreatic hyperenzymemia (CAPH), and control subjects with functional dyspepsia. In patients with borderline or positive anti-tTG values, the team also looked at anti-endomysium autoantibodies. They offered duodenal biopsy to all patients with positive results. They found just one patient out of 72 (1.4%) with autoimmune pancreatitis who had already been diagnosed with celiac and was following a gluten-free diet, while one case out of 71 (1.4%) with chronic pancreatitis and one out of 92 (1.1%) controls were found to have celiac disease. They found no celiac disease in the CAPH group. By contrast, a high prevalence of cases with ulcerative colitis was found in the AIP group (13.8%). Despite an alleged connection between celiac disease and several autoimmune disorders, the data in this study do not support celiac screening for autoimmune pancreatitis patients. Celiac screening may be useful in other pancreatic disorders, but further study is needed to make a determination. Source: Nutrients. 2018 Aug 24;10(9). pii: E1157. doi: 10.3390/nu10091157.
  2. Celiac.com 08/31/2018 - Until recently the only way to get a proper screening for celiac disease would be to convince your doctor or health care provider to order the tests, and then pay a visit to the lab where they would draw a test tube or two full of blood. Depending on your situation, it can sometimes be difficult to convince your doctor or health care provider to actually order the tests. They can also be expensive, even if you are lucky enough to have decent health insurance coverage. Did you know that you can now use a LetsGetChecked home screening kit to carry out a full celiac disease screening in the privacy of your own home? I recently took the opportunity to use their kit to re-screen my son for celiac disease, as it's been a while since his last screening, and he should be getting screened annually. The test kit arrived quickly, and upon opening it I found all the items necessary to collect a specimen, plus a very clear set of eight step-by-step instructions, complete with graphics, to make it super easy to follow. The kit requires “activation,” which was done in just a few minutes on their Web site. The activation process allows the lab to connect you with your specimen, so that you can get your results via their Web site. After activating my kit we moved on to the specimen collection, which went far easier than I expected. The kit comes with a few lancets, and we used only one of them to painlessly prick my son's finger. We gathered around 8 or 9 drops of his blood to fill the collection tube. After snapping the lid on it, we put it in the addressed, stamped envelope and dropped it off at our local UPS Store. A few days later I was surprised to get a call from a their medical team who took the time to go over my son's results with me over the phone—which, happily for my son—were negative! I also received an email with the results, and I was able to view them on their Web site as well. Whether you want to save money, wish to have more privacy with your testing and results, or would like to get screened quickly—using LetsGetChecked kit to screen for celiac disease makes a lot of sense. I've already recommended it to several friends and family members, and believe that this is one of the best home test kits available, and will be a big part of the future of celiac disease screening.
  3. Celiac.com 04/25/2017 - A recent issue of JAMA, the US Preventive Services Task Force (USPSTF) critically examines screening for celiac disease in asymptomatic adults, adolescents, and children. Celiac disease exhibits a broad spectrum of symptoms, from subtle or no symptoms to severe malabsorption. Celiac diagnoses have increased significantly over the past few decades, in part because of greater awareness, but possibly because of an actual increase in disease rates. Researchers estimate current rates of celiac disease at 0.71% among US adults, and 0.76% among US children. However, most celiac disease in the population remains undetected, despite wide availability of accurate serologic tests. Screening may be a good way to detect the disease, especially in people who have known risk factors, but have not yet developed symptoms. Noting a profound lack of supporting evidence in the medical literature, the USPSTF states bluntly that "the current evidence is insufficient to assess the balance of benefits and harms of screening for celiac disease in asymptomatic persons." The group recommends more research in this area. USPSTF admits its review of this topic might be criticized as premature, but emphasizes the need for data to provide direction with regards to best practices. The group used rigorous methodology to assess the effectiveness of celiac disease screening in an asymptomatic population, and found the resulting evidence to be thin in inconclusive. Their conclusion and recommendation will likely disappoint numerous clinicians, and more than a few patients. By design, the task force focuses solely on asymptomatic persons, or persons with unrecognized symptoms. They note that screening the general population could potentially detect not only asymptomatic patients, but also patients who lack typical symptoms such as weight loss, diarrhea, or malabsorption. In summary, current evidence on the effectiveness of screening for celiac disease in asymptomatic populations is scarce or absent and certainly insufficient to recommend for or against screening, as indicated in the USPSTF Recommendation Statement. Remember, the USPSTF is not anti-screening, they are pro-screening evidence. Since most celiac disease is undetected, and may present with variable symptoms, the group states that it is "reasonable that clinicians should have a low threshold for testing for celiac disease, especially in high-risk populations such as those with an affected family member or type 1 diabetes mellitus." Clinicians should routinely seek information on the patient’s family history of celiac disease. As celiac testing becomes easier and cheaper, and as gluten-free food becomes more available, it becomes more important for researchers provide the data to determine the best practices for screening and treating celiac disease. They stress the need for more comprehensive studies to assess best celiac screening practices in both high-risk groups, and in the general population, which includes most people with undetected celiac disease. The also note the possibility that the rise in gluten-free dieting by people without an official celiac diagnosis might be an indication of the uncertainty of current screening and diagnostic approaches. Source: Jamanetwork.com
  4. Celiac.com 05/19/2017 - Did you know that now, according to Beyond Celiac 83% of those with celiac disease are misdiagnosed or undiagnosed? Did you know that the average time a person waits to be correctly diagnosed, according to Daniel Lefler, M.D., M.S, of the Celiac Center at Beth Israel Deaconness Medical Center is still six to 10 years? This has changed little in the past 10 years, even though celiac disease can lead to a number of other disorders including infertility, reduced bone density, neurological disorders, some cancers, and other autoimmune diseases. Over a four year period, people with undiagnosed celiac disease cost an average of $3,964 more than the healthy individuals (Source: Long et al, 2010. Did you know that 5 - 22% of people with celiac disease have an immediate family member (first degree relative who also has celiac disease, and that there isn't yet a pharmaceutical treatment or cure for it? In 2009 WebMD reported that, in the USA, celiac disease has quadrupled over the last 50 years, yet many people who have the disease remain undiagnosed. Still Dr. Stefano Guandalini, N.D. Director of the Celiac Disease Center at the University of Chicago told WebMD, "Many of these people have no symptoms, but many do have symptoms that are not recognized for what they are. We believe that only five percent of people with celiac disease know they have it". Is there any wonder that a woman at the dietician's office at our local hospital where I sometimes volunteer did not know she had celiac disease? This is because she was only experiencing symptoms of joint and muscle pains, abdominal pain and laboratory tests only showed anemia. She was first referred to an orthopedic specialist, then an internist, and neither checked for celiac disease or questioned her further. "Hello!!" Are there still general practitioners out there who are not aware that there is a blood test for celiac disease? Some people experience symptoms found in celiac disease such as a "brain fog," depression, ADHD like behavior, abdominal pain, bloating, diarrhea, constipation, headaches, bone or joint pain, and chronic fatigue when they have gluten in their diet, yet do not test positive for celiac disease. The terms non-celiac gluten sensitivity (NCGS) and non-celiac wheat sensitivity (NCWS) are generally used to refer to this condition. When removing gluten from their diet it removes symptoms. At my first biopsy of the bowel the gastroenterologist failed to biopsy the jejunum. My blood test was positive, the biopsy of the dermatitis herpetiformis proved positive too, and it wasn't until I insisted on a second biopsy of my jejunum that I was diagnosed. If I had not been persistent, I would have given up after the first biopsy and continued itching and ingesting gluten. Persistence, or stubborn determination (i.e. knowing my own body) paid off, but it took a year for the dermatitis herpetiformis to totally rescind, most particularly the sores on my scalp. You know your own body better than anyone; you know when something is wrong. If your grocery store fails to give you good service you go elsewhere. The Celiac Disease Foundation, both in Canada and the United States, can help you find the right doctor to discuss your symptoms so you can get diagnosed and treated. Shop and find your own healthcare practitioner. Do not allow a doctor tell you that you are neurotic, perimenopausal, or their favorite: "stressed." Since there are more than 200 known celiac disease symptoms which may occur in the digestive system or other parts of the body, and some people develop celiac disease as a child, others as an adult, you owe it to yourself to keep checking and researching and reading magazines like Celiac.com's Journal of Gluten Sensitivity, because, according to the Mayo Clinic, there is no cure for celiac disease. The American Journal of Gastroenterology, at ScienceDirect.com, offers a nationwide view of celiac disease, and conducted two randomized trials that tested strategies of early or delayed gluten introduction in infants, and neither strategy appeared to influence the risk for celiac disease. They also indicated that breastfeeding did not protect against celiac disease. "While disappointing, these results should spur the study of wider environmental risk factors beyond infant feeding, such as intrauterine and perinatal exposure as well as environmental influences later in life, including drug exposure, microbial infections, and the mictobionme. Given that celiac disease can develop at any age, it is imperative to study these proposed triggers so as to elucidate the loss of tolerance to gluten and to develop future intervention strategies." At the start of the Gastroenterology study, between 2000 and 2001 - 11.1 out of every 100,000 people had celiac disease. Toward the end of the study - between 2008 and 2010 it was up to 17.3 out of every 100,000 people. However, researchers noted that the incidence of celiac disease plateaued after 2004. It is no big surprise that they believe, according to Dr. Stefano Guandalini, M.D. "that only about 5 percent of people with celiac disease know they have it." Web MD reported that "Celiac Disease had quadrupled." Many physicians I approached whilst completing this survey indicated it was physician knowledge of the signs and symptoms of celiac disease that has caused a greater increase in celiac testing and the use of a simple blood test (tTG-IgA). The Tissue Transglutaminase Antibodies test will be positive in about 98% of patients with celiac disease who are on a gluten-containing diet. The same test will come back negative in about 98% of healthy people without celiac disease. Although rare, patients with celiac disease could have a negative antibody test result. There is also a slight risk of a false positive test result, especially for people with associated autoimmune disorders like Type 1 Diabetes, autoimmune liver disease, Hashimoto's thyroiditis, psoriatic or rheumatoid arthritis, and heart failure. This test is not good for someone who has been following a gluten-fre diet on their own. A biopsy of the small intestine is still considered the only way to diagnose celiac disease by many doctors. Many parents are reluctant to submit their young child to a biopsy of the Jejeunum and have used only blood tests, including the IgA Endomysial antibody (EMA). This test has a specificity of almost 100% but it is not as sensitive as the tTG-IGA test, because about 10% of people with celiac disease do not have a positive EMA test. Also, it is VERY expensive in comparison to the tTG-IgA and it requires the use of primate esophagus or human umbilical cord, so it is usually reserved for difficult to diagnose patients. The Total Serum IgA is used to test for IgA deficiency, a condition associated with celiac disease that can cause a false negative tTC-IgA or EMA result. If you are IgA deficient, our doctor can order a DGP or tTg-IgC. The decimated gliadin peptide (DGP-IgA and IgG) is a test that can be used to further screen for celiac disease in individuals with IgA deficiency or people who test negative for tTg or EMA antibodies. Even though it is very rare, it is possible for someone with celiac disease to have negative antibody test results. So please do not become discouraged even with negative results, if you are still experiencing symptoms talk with your physician and undergo further medical evaluation. Keep in mind that some of these tests are not medically covered by insurance. Did you know that you can get genetic testing for celiac disease? People with celiac disease carry one or both of the HLA DQ2 and DQ8 genes. So do up to 25 - 30% of all people. Carrying HLA DQ2 and/or DQ8 is not a diagnosis of celiac disease, nor does it mean you will ever develop celiac disease. However, if you carry HLA DQ2 and/or DQ8 your risk of developing celiac disease is 3% instead of the general population risk of 1%. Since celiac disease is genetic this means it runs in families. First degree family members (parents, siblings, children) who have the same genotype as the family member with celiac disease, have up to a 40% risk of developing celiac disease. The overall risk of developing celiac diseases when the genotype is unknown is 7% to 20%, which is a big difference! We cannot blame ALL physicians for the lack of a correct diagnosis. It is one of the most puzzling, multi-faceted diseases, and a patient going into their family physician's office may have very vague symptoms. Thousands of dollars may be spent on blood tests, referrals to specialists, x-rays, and scans before a diagnosis is found. There is nothing more deflating or frustrating to someone who has a myriad of legitimate symptoms than to be told that they are either depressed, stressed or suffering from an overactive imagination. Sources: The American Journal of Gastroenterology https://celiac.org http://www.beyondceliac.org
  5. Celiac.com 03/16/2017 - When screening arthritis patients for celiac disease, should HLA be done before serology? During the past decades, an accumulating evidence shows a dramatic rise in the frequency of autoimmune diseases, including rheumatoid arthritis and gastrointestinal conditions, such as celiac disease. HLA genes have been shown to be strongly associated with numerous autoimmune diseases, including rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA) and celiac disease. A team of researchers recently set out to assess the performance of celiac disease associated serology in face of a rheumatologic patient, when gluten enteropaty is suspected. The research team included Hakim Rahmoune, Nada Boutrid, Mounira Amrane, and Belkacem Bioud. They are variously affiliated with the Pediatrics Department and the Biochemistry Department of Setif University Hospital at Setif-1 University in Algeria. The main question they sought to answer was: Should HLA be done prior to the serology? Could unnecessary serial serological celiac disease screening in such rheumatology patient be avoided by performing an HLA typing, as a long-life marker of genetically celiac disease-susceptible patients? Serogenetic screening without the requirement for follow-up small bowel biopsies provides a flexible, cost-effective methodology that could be widely applied to obtain accurate estimates of the prevalence of celiac disease in large group studies. Source: International Journal of Celiac Disease, 2017, Vol. 5, No. 1, xx. DOI:10.12691/ijceliac disease-5-1-2
  6. Scott Adams

    Celiac Disease Screening

    Celiac.com 02/08/2007 - For anyone with a family history of celiac disease or of disorders such as thyroid disease, anemia of unknown cause, type I diabetes or other immune disorders or Downs syndrome, doctors may suggest routine screening. Otherwise, patients are generally screened on a case by case basis according to individual symptoms. People with celiac disease have abnormally high levels of associated antibodies, including one or more of the following: anti-gliadin, anti-endomysium and anti-tissue transglutaminase, and damage to the villi (shortening and villous flattening) in the lamina propria and crypt regions of their intestines when they eat specific food-grain antigens (toxic amino acid sequences) that are found in wheat, rye, and barley. Antibodies are the specialized proteins the immune system uses to break down and eliminate foreign substances from the body. In people with celiac disease, the immune system treats gluten as a foreign invader and produces elevated levels of antibodies to get rid of it, causing symptoms and associated discomfort. Testing & Diagnosis A blood test, such as anti-tissue transglutaminase and anti-endomysial antibodies, can detect abnormally high antibody levels, and is often used in the initial detection of celiac in people who are most likely to have the disease, and for those who may need further testing. Since the immune system of a person with celiac treats gluten as a foreign substance and increases the number of antibodies, elevated levels of these antibodies are a sign of celiac disease. To confirm the diagnosis, your doctor may need to do a biopsy, that is, microscopically examine a small portion of intestinal tissue to check for celiac associated damage to the small intestine. To do this, your doctor inserts a thin, flexible tube (endoscope) through your mouth, esophagus and stomach into your small intestine and takes a sample of intestinal tissue to look for damage to the villi (tiny, hair-like projections in the walls the small intestine that absorb vitamins, minerals and other nutrients).
  7. Celiac.com 08/15/2016 - On May 3rd, 2016, as part of an ongoing effort to learn more about celiac disease, the U.S. Preventive Services Task Force (USPSTF) released its first-ever draft recommendation statement, and draft evidence review. The statement basically says that there just isn't enough evidence to adequately weigh the benefits and harms of celiac disease screening in asymptomatic patients. This is an "I" recommendation that does not apply to patients with symptoms of celiac disease such as diarrhea, abdominal pain and unexplained weight loss. They basically call for "[m]ore evidence on screening for celiac disease…before the task force can recommend for or against screening people who don't have any signs or symptoms of the condition," said USPSTF member Alex Krist, M.D., M.P.H., in a news release. "In the face of unclear evidence, physicians should use their clinical judgment when deciding whom to screen," Krist added. The USPSTF pointed out that their future recommendations for screening patients would benefit from research into: The effectiveness of targeted screening in patients at increased risk for celiac disease The accuracy of serological markers in asymptomatic patients, particularly those with risk factors The effect of treatment of celiac disease in asymptomatic patients who have positive blood tests for celiac disease, and The clinical outcomes such as changes in health and quality of life in people who are screened versus people who are not screened Read more at: AAFP.ORG.
  8. Celiac.com 06/29/2016 - As part of a call for public comment that expired on May 30, 2016 at 8:00 PM EST, the U.S. Preventive Services Task Force issued a Draft Recommendation Statement regarding celiac disease screening. The draft was distributed solely for the purpose of receiving public input. It has not been disseminated otherwise by the USPSTF. The final Recommendation Statement will be developed after careful consideration of the feedback received and will include both the Research Plan and Evidence Review as a basis. The statement is intended for adults, adolescents, and children who do not have signs or symptoms of celiac disease. The statement is basically a call for more evidence. It expresses the USPSTF conclusion that the current evidence is insufficient to assess the balance of benefits and harms of screening for celiac disease in asymptomatic persons. The USPSTF website regarding this announcement includes information on the Rationale, Clinical Considerations, Other Considerations, Discussion, Recommendations of Others, and References. Current testing recommendations include: The American College of Gastroenterology recommends that asymptomatic persons with a first-degree relative who has a confirmed diagnosis of celiac disease be considered for testing. Patients with type 1 diabetes mellitus should be tested for celiac disease if there are any digestive symptoms, signs, or laboratory evidence suggestive of celiac disease. The U.K. National Institute for Health and Care Excellence recommends offering serologic testing for celiac disease to persons with a first-degree relative with celiac disease or persons with type 1 diabetes mellitus or autoimmune thyroid disease upon diagnosis. Serologic testing for celiac disease should be considered for persons with any of the following: metabolic bone disorder (reduced bone mineral density or osteomalacia), unexplained neurologic symptoms (particularly peripheral neuropathy or ataxia), unexplained subfertility or recurrent miscarriage, persistently elevated liver enzymes with unknown cause, dental enamel defects, Down syndrome, or Turner syndrome. The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition recommends testing for celiac disease in asymptomatic children who have conditions associated with celiac disease (type 1 diabetes mellitus, autoimmune thyroiditis, Down syndrome, Turner syndrome, Williams syndrome, selective IgA deficiency, and first-degree relatives with celiac disease). It recommends testing asymptomatic children who are at risk beginning around age 3 years, provided they have had an adequate gluten-containing diet for at least 1 year before testing. It recommends that asymptomatic persons with negative serology who are at risk be considered for repeat testing.19 Read more at: uspreventiveservicestaskforce.org
  9. Celiac.com 01/25/2016 - The latest research says that most fail to recommend celiac screening for first degree relatives, although some doctors are better than others. In a recent study, researchers tried to get an idea of just how frequently celiac disease patients receive a physician-issued recommendation for first-degree relative screening. The research team included Abhik Roy, Colin Smith, Constantine Daskalakis, Kristin Voorhees, Stephanie Moleski, Anthony J DiMarino, David Kastenberg. They are variously associated with the Division of Biostatistics, the Division of Gastroenterology and Hepatology, the Department of Medicine at Thomas Jefferson University, Philadelphia, Pennsylvania, USA, and the National Foundation for Celiac Awareness in Pennsylvania. For their study, the research team conducted a 12-question survey assessing whether celiac disease patients receive a physician recommendation to screen first-degree relatives for celiac disease, and the impact of such a recommendation, was validated with outpatients in a university gastroenterology practice, called "University"patients. The 12-question survey was then distributed online to members of the National Foundation for Celiac Awareness (NFCA). The team then collected results over 3 months, and used univariate analysis to compare cohort means, and to assess the association between demographic and diagnostic factors and first-degree relative screening recommendations. A total of 87 University patients participated in the validation phase. Test-retest reliability of 4 key survey questions was high, with a Kappa coefficient >0.80. The team based its main analyses on data from 677 NFCA and 82 University respondents. Most respondents were female, with an average age of 45 years. Nearly 80% of University patients received recommendation for celiac disease screening for first-degree relatives, compared with just 44% of the NFCA respondents (p < 0.001). Of patients who did receive a screening recommendation, from either group, 98% percent discussed the recommendation with family members, leading to celiac disease screening in 71% of University patients, and 79% of NFCA respondents, and to a celiac disease diagnosis in 18% of University patients, and 27% of NFCA respondents. Physicians commonly fail to mention to their celiac disease patients the importance of screening first-degree family members. Because such screening is so effective, the researchers are suggesting that making such screening recommendations may increase the diagnosis of celiac disease in high risk individuals. Source: Journal of Gastroenterology and Hepatology Research, Vol 4, No 12 (2015)
  10. Celiac.com 11/09/2015 - Can mass screening for celiac disease help enough people, and improve enough lives to justify the cost and effort? While celiac disease fulfills several WHO criteria for mass screening, such as high prevalence, available treatment and difficult clinical detection, it remains unproven that treatment of asymptomatic celiac disease can lower the risk of severe complications and improve quality of life, or that it is cost-effective. A research team recently set out to review the literature on screening for celiac disease in relation to the current World Health Organization (WHO) criteria for mass screening. The team included Jonas F Ludvigsson, Timothy R Card, Katri Kaukinen, Julio Bai, Fabiana Zingone, David S Sanders, and Joseph A Murray. The research team is variously affiliated with the Department of Paediatrics, Örebro University Hospital, Örebro, Sweden, the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, the Department of Epidemiology and Public Health, University of Nottingham, Nottingham, UK, the School of Medicine, University of Tampere, Tampere, Finland, the Department of Internal Medicine, Hospital, Tampere University Hospital, Tampere, Finland, the Department of Internal Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland, the Department of Medicine, C Bonorino Udaondo Gastroenterology Hospital, Universidad del Salvador, Buenos Aires, Argentina, the Department of Medicine and Surgery, University of Salerno, Salerno, Italy, the Regional GI and Liver Unit, Royal Hallamshire Hospital, Sheffield, UK, the Department of Medicine, Department of Immunology, Mayo Clinic College of Medicine, Rochester, USA. The team conducted a PubMed search for all indexed papers on celiac disease screening published from 1900 until mid-2014. For all relevant abstracts the team read the corresponding paper in full. Their search revealed that current evidence is not sufficient to support mass screening for celiac disease. However, they do note that this strategy will help most patients with celiac disease, so active case-finding may be appropriate. They also note that, even though proof of benefit is lacking, screening for celiac disease may be appropriate in high-risk groups. Source: United European Gastroenterology Journal April 2015 vol. 3 no. 2 106-120
  11. Celiac.com 08/10/2015 - The presence of specific human leukocyte antigen-DQ2 and DQ8 seems to be necessary for celiac disease development, but its usefulness for screening is still uncertain. A research team recently set out to conduct a systematic review and meta-analysis of the diagnostic performance of human leukocyte antigen typing tests for celiac disease screening. The research team included A. Díaz-Redondo, J. Miranda-Bautista, J. García-Lledó, J.P. Gisbert, and L. Menchén. They are variously affiliated with the Hospital General Universitario Gregorio Marañón in Madrid, Spain, and with the Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Madrid, Spain. The team conducted a systematic review of published studies assessing accuracy of human leukocyte antigen DQ2 and DQ8 typing for the detection of celiac disease. They searched MEDLINE and EMBASE for the period running from 1st January 2004 until 31st December 2013 and used two independent researchers to carry out selection and classification of studies, data extraction and analysis. The team conducted meta-analysis that combined sensitivities, specificities and likelihood ratios of HLA-DQ2 and DQ8 for the diagnosis of celiac disease and ended up with six studies that included a total of 1303 people. The results showed pooled sensitivity at 98%, with 95% confidence interval: 97-99. Overall specificity was 45% (95% confidence interval: 41-48). Regarding specificity, studies were heterogeneous and a the team ran a subgroup analysis according to the type of population included. Overall negative likelihood ratio was 0.05 (0.03-0.09). Because it offers high sensitivity and low negative likelihood ratio, the team concludes that human leukocyte antigen-DQ2/DQ8 typing makes an appropriate test for ruling out celiac disease in the general population suffering related symptoms, and even more in at risk population. Source: Rev Esp Enferm Dig. 2015 Jul;107(7):423-429.
  12. Celiac.com 07/09/2015 - Children presenting for rheumatology evaluation have undiagnosed celiac disease at double the rates of the general population, says the latest study. However, current clinical guidelines do not consider patients with rheumatic conditions to be at high risk for celiac disease despite numerous reported associations between the two in adults and children. A team of researchers set out to assess the prevalence of celiac disease among kids receiving a rheumatology evaluation. The research team included Yekaterina Sherman, BA, Rose Karanicolas, MD, Brittany DiMarco, BA, Nancy Pan, MD, Alexa B. Adams, MD, Laura V. Barinstein, MD, L. Nandini Moorthy, MD, and Thomas J. A. Lehman, MD. They are variously affiliated with the Division of Pediatric Rheumatology, Hospital for Special Surgery, New York, New York; the Division of Rheumatology, Mount Sinai Medical Center, New York, New York; and the Division of Pediatric Rheumatology, Robert Wood Johnson Medical School in New Brunswick, New Jersey. The team conducted celiac disease screenings on a total of 2,125 patients presenting for initial evaluation by the Division of Pediatric Rheumatology at the Hospital for Special Surgery between June 2006 and December 201, as a part of the standard initial serologic evaluation. The team then reviewed the charts at the end of this period. From this information, the team diagnosed celiac disease in a total of 36 patients (30 girls, 6 boys, mean age 9.4 ± 4.3 years, range 2–16 years), after serologic testing and evaluation by pediatric gastroenterology. Eight additional patients with known celiac disease diagnoses presented during this time period. The total prevalence of celiac disease over this 6.5-year period was 2.0%. The most commonly reported complaints among patients diagnosed with celiac disease were myalgias, arthralgias, and skin rash. Less frequently, patients reported gastrointestinal complaints including abdominal pain, nausea, and diarrhea. All patients reported improvement or complete resolution of their musculoskeletal symptoms after beginning a gluten-free diet. In this study, the team found 36 new cases of celiac disease among children presenting for rheumatology evaluation, for an overall prevalence rate of 2.0%. The majority of patients who ultimately received a diagnosis of celiac disease presented with extra-intestinal manifestations. These results underscore the importance of celiac disease screening in children receiving a rheumatology evaluation. Source: http://pediatrics.aappublications.org/content/early/2015/06/09/peds.2014-2379.abstract
  13. Hello, I finally decided to get screened for celiac disease after many years of suspecting I have a gluten intolerance or sensitivity. Over the last year I have become much more intuitive in my eating, and have scaled way back on gluten because of how I felt after eating it. Still, I did not strictly avoid it or completely eliminate it -- I simply didn't make it a staple in my diet. But after finding out I have a family history of celiac disease, I decided it would be better to know for sure if I really need to fully eliminate it. If I'm simply sensitive or intolerant, I will keep on eating like I was, but if I have celiac disease I would not want to be unwittingly damaging my body. Since I wasn't consuming a ton of gluten, I decided to up the ante for the 2 weeks prior to my blood test and eat a bagel every morning and a sandwich or pasta every night. Well, after a week of this challenge I feel absolutely terrible: tired, bloated, foggy. I can't wait to go back to the "gluten-life" diet (or, gluten-free if necessary) I was consuming before I undertook this endeavor to be tested. I saw my doctor today and she ordered "Celiac Disease Panel, Adult - Q15980" through Quest Labs and I am going on Monday for the blood draw. But a friend who has celiac told me to make sure they test all 47(?) markers, not just the 2 main markers? I am not sure what that means, but now I'm worried the doctor didn't order all the possible tests, and this screening process will drag on and on... So my questions are: 1. What tests specifically do I need to ask my doctor to order for a COMPLETE blood screen? 2. How much gluten do I need to be consuming daily until testing is complete? I was not on a gluten-free diet, but it was sort of "gluten-lite" in that I did not consume gluten every single day or in large amounts. So for the last 2 weeks in preparation for the test I have been eating 4+ pieces of bread a day -- and feeling like hell Is this much necessary? I don't know if I can keep it up until a possible endoscopy. 3. Should I just schedule an appointment with a gastroenterologist now anyway? If I don't have celiac, I have some sort of gastrointestinal problem that is causing me symptoms, so I would need to see one anyway I would think and perhaps then it will speed up this testing process... Thank you in advance to whoever has the time or expertise to answer any or all of my questions! This forum has been tremendously helpful during this often confusing and (sometimes terrifying) process
  14. Celiac.com 03/10/2015 - Up to now, celiac disease has been described only in sporadic cases of obesity. A research team recently set out to evaluate retrospectively celiac disease rates in a large group of overweight/obese children and adolescents. The research team included Raffaella Nenna, Antonella Mosca, Maurizio Mennini, Raffaele E. Papa, Laura Petrarca, Roberta Mercurio, Monica Montuori, Alessandra Piedimonte, Maria Bavastrelli, Ilaria C. De Lucia, Margherita Bonamico, and Andrea Vania. For their study, the team consecutively evaluated 1,527 overweight/obese children and adolescents, 10 girls and 7 boys had positive celiac serology and showed villous atrophy. All celiac patients immediately began a well-balanced gluten-free diet, and rapid weight loss followed. The study shows that celiac rates in overweight/obese children are similar to rates in the general Italian pediatric population, and that those children benefit from proper diagnosis and a healthy gluten-free diet. Source: Journal of Pediatric Gastroenterology & Nutrition: March 2015 - Volume 60 - Issue 3 - p 405–407. doi: 10.1097/MPG.0000000000000656
  15. Celiac.com 06/23/2014 - Previous studies of adults have shown a strong connection between celiac disease and irritable bowel syndrome, but there has been very little data for children. A research team recently set out to determine rates of celiac disease in children with ongoing abdominal pain. The researchers included Fernanda Cristofori, MD; Claudia Fontana, MD; Annamaria Magistà, MD; Teresa Capriati, MD; Flavia Indrio, MD; Stefania Castellaneta, MD; Luciano Cavallo, MD; Ruggiero Francavilla, MD, PhD. They are variously affiliated with the Interdisciplinary Department of Medicine, Pediatric Section at the University of Bari ’s Giovanni XXIII Hospital in Bari, Italy, the Department of Pediatrics at Ravenna Hospital in Ravenna, Italy, and the Department of Pediatrics at San Paolo Hospital in Bari, Italy. For their prospective observational study, the team tested 782 children who presented with abdominal pain-related disorders, 270 with IBS, 201 with functional dyspepsia, and 311 with functional abdominal pain. All subjects were treated between 2006 and 2012 at the university hospital of Bari, the regional tertiary referral center for gastrointestinal disorders. As a primary screen for celiac disease, the researchers used serum tests for immunoglobulin A, immunoglobulin A antitissue transglutaminase, and endomysial antibodies. They then confirmed the diagnosis with upper endoscopy, including multiple duodenal biopsies. Overall, fifteen patients tested positive for celiac. They included 12 children with IBS (4.4%; 95% confidence interval [CI], 2.5% - 7.6%), 2 children with functional dyspepsia (1.0%; 95% CI, 0.2% - 3.5%), and 1 child with functional abdominal pain (0.3%; 95% CI, 0.1% - 1.7%). The team concluded that treating IBS as a high-risk condition for celiac disease might be help pediatric primary care specialists extend celiac disease screening to children with IBS rather than testing all children with recurrent abdominal pain, Source: JAMA Pediatrics. Published online April 21, 2014.
  16. Celiac.com 05/09/2014 - Even though we now have cheap, readily available celiac blood screening tests, more than eight out of every ten people with celiac disease remain undiagnosed, and the average time to in diagnosis of symptomatic individuals with celiac disease ranges from about six to eleven years. A team of researchers recently set out to assess if patient-centered barriers have a role in stifling serologic screening for celiac disease in individuals from high-risk populations. The research team included Erika M. Barbero, Shawna L. McNally, Michael C. Donohue, and Martin F. Kagnoff. They are variously affiliated with the Department of Medicine’s Division of Gastroenterology, and the Department of Family and Preventive Medicine’s Division of Biostatistics and Bioinformatics at the University of California San Diego in La Jolla, California, and with the Harvard Center for Population and Development Studies in Providence, Rhode Island. The team recruited, from the general population, 119 adults at a higher risk for celiac disease. These participants answered a survey/questionnaire that addressed demographic information, celiac disease related symptoms (gastrointestinal and extra-intestinal), family history, co-morbid diseases and conditions associated with celiac disease, and patient-centered barriers to screening for celiac disease. The team then screened all participants celiac disease using the IgA tissue transglutaminase antibody (IgA tTG), confirming positive results with an anti-endomysial antibody (IgA EMA) test. They found two significant barriers to serologic testing across the participant pool. The first was lack of knowledge of their higher risk level celiac disease. The second was a lack of knowledge about where and how to get tested. They also noted that lack of access to a doctor ordered celiac screening test was a significant barrier for participants earning less than $25,000/year and those under the average participant age. This was also strongly correlated with participants lacking health insurance. Patients with negative IgA tTG and those who tested positive showed similar symptoms and co-morbid conditions. There are a number of major patient-centered barriers stifle celiac blood test screening. These patient-centered barrier contribute to the delayed celiac detection and diagnosis. Education of the public and health care professionals about celiac disease symptoms, risk factors, and serologic testing can help to reduce these barriers. Source: BMC Gastroenterology 2014, 14:42. doi:10.1186/1471-230X-14-42
  17. Celiac.com 03/03/2014 - Spotting celiac disease early is important for optimal patient outcome. However, serological markers of celiac disease aren't much good for spotting mild histopathological lesions in adults at risk for celiac. A team of researchers recently set out to assess the usefulness of human leukocyte antigen (HLA)-DQ2/8 genotyping, followed by duodenal biopsy for the detection of celiac disease in adult first-degree relatives (FDRs) of patients with celiac disease. The research team included L. Vaquero, A. Caminero, A. Nuñez, M. Hernando, C. Iglesias, J. Casqueiro, and S. Vivas. They are variously affiliated with the Gastroenterology Unit, the Pathology Department, and the Pediatric Department of the University Hospital of León, Altos de Nava, with the Institute of Molecular Biology (INBIOMIC), the Microbiology Department and the Institute of Biomedicine (IBIOMED) at the University of León, all in León, Spain. For their study, the team looked at ninety-two adult DQ2/8 positive FDRs. They offered duodenal biopsy irrespective of the serology result or associated symptoms. They then noted clinical features, associated autoimmune diseases and biochemical parameters. The team conducted duodenal biopsies on sixty-seven FDRs, averaging 34 years of age. Thirty-two of those patients (48%) showed histopathological changes, which broke down as follows: twelve patients Marsh I (18%), one Marsh II (1.5%), four Marsh IIIA (6%), five Marsh IIIB (7.5%) and ten Marsh IIIC (15%). Seventeen of the sixty-seven patients (25%) showed positive serological markers, with only one showing Marsh I and the remainder presenting some degree of duodenal atrophy (Marsh III). Thirty-three of the sixty-seven patients (54%) suffered gastrointestinal symptoms, with dyspepsia being the most common complaint. The distribution of symptoms, anaemia and autoimmune disease was not changed by a patient's duodenal histopathological stage. Overall, in first-degree relatives, current blood-based screening would diagnose 50% of the cases that displayed any celiac disease characteristic, and miss 6% of the cases with mucosal atrophy. From these results, the team concludes that adult first-degree relatives of patients with celiac disease can benefit from a screening strategy on the basis of HLA-DQ genotyping, followed by a duodenal biopsy. FDRs with gastrointestinal and other symptoms may see improvement on a gluten-free diet. Source: Eur J Gastroenterol Hepatol. 2014 Mar;26(3):263-7. doi: 10.1097/MEG.0000000000000020.
  18. Celiac.com 07/11/2013 - A team of researchers wanted to better understand screening practices for celiac disease in patients with type 1 diabetes across North America. One question they sought to answer was whether diabetes centers screen for celiac disease in type 1 diabetes more frequently than other facilities. The research team included S.M. Simpson, E.J. Ciaccio, S. Case, N. Jaffe, S. Mahadov, B. Lebwohl, P.H. Green. All except Case are affiliated with the Celiac Disease Center at Columbia University, New York, USA. Shelley Case runs her own nutrition consulting business in Regina, Saskatchewan. For their study, the team conducted a survey with 27 questions on screening practices for celiac disease in patients with type 1 diabetes. The questions were compiled by experts in celiac disease and diabetes. The team sent surveys by email to diabetes educators and dietitians throughout the United States and Canada between December 2010 and May 2011. They received 514 responses from 484 endocrine clinics, diabetes clinics, private practices, community nutrition centers, and inpatient centers. Thirty-five percent of these locations screened for celiac disease, with endocrine clinics reporting screening at the highest rate of eighty percent. Not surprisingly, the most common test celiac disease test was tissue transglutaminase, while the most frequently recommended treatment of confirmed celiac disease was a gluten-free diet. However, only 365 respondents (71%) recommended biopsy in patients with positive blood results. More than half of those responding (55.3%) reported that patient symptoms improved once they adopted a gluten-free diet. Staff at endocrine clinics were most likely to suggest celiac disease testing for patients with type 1 diabetes. Due to low screening frequency as well as inconsistency in management of positive celiac disease blood tests, the research team is calling for increased education regarding celiac disease in patients with type 1 diabetes, along with the adoption of uniform protocols. Source: Diabetes Educ. 2013 May 14.
  19. Celiac.com 08/19/2013 - Data from blood studies suggest that about 1% or so of North Americans have celiac disease. However, there is no good screening data based on small intestinal biopsy performed during routine endoscopic evaluations. Researcher H.J Freeman recently set out to determine rates of detection of adult celiac disease via duodenal screening biopsies over a thirty year period. For his study, he looked at patients referred between January 1982 and December 2011 for evaluation of gastrointestinal symptoms that required elective investigative upper endoscopic assessment, and who underwent duodenal biopsies to determine whether changes of adult celiac disease were present. Freeman looked at a total of 9665 patients, including 4008 (41.5%) males and 5657 (68.5%) females, who underwent elective endoscopies and duodenal biopsies. Overall, 234 patients (2.4%) exhibited changes of celiac disease. That included 73 males (1.8%) and 161 females (2.8%). During the first 20 years, the number of biopsy-positive patients in five-year intervals progressively decreased, while, during the next 10 years, the number progressively increased. From this study, the team concludes that celiac disease is far more common in specialist practice than has been suggested in the evaluation of healthy populations using serological screening studies. Endoscopic duodenal biopsy is an important way to spot underlying celiac disease and should be routinely considered in all patients undergoing an elective endoscopic evaluation. They also note that the appearance of biopsy-defined celiac disease may be influenced by non-inherited factors, possibly environmental, which alter its detection over time. Source: Can J Gastroenterol. 2013 Jul;27(7):405-8.
  20. Celiac.com 08/02/2013 - A great deal of effort goes into determining the best procedures for screening for celiac disease. Ideally it would be great to test everyone, but that is currently too expensive on such a large scale. So, one of the things researchers study is how to get the best results with limited resources. To better understand the cost-effectiveness of universal screening for celiac disease versus screening only patients who are at risk for or showing symptoms of celiac disease, a team of researchers looked specifically at the high risk, and associated costs, of non-traumatic hip and vertebral fractures if celiac disease is untreated or undiagnosed. Their results appear in Clinical Gastroenterology and Hepatology. The team found that the current standard practice of screening adolescents who are either symptomatic or at high-risk for celiac disease proves to be more cost-effective than universal screening. They also found that screening helps to prevent decreased bone mineral density, which can affect up to 70 percent of untreated celiac patients, and often leads to osteoporosis and non-traumatic hip and vertebral fractures. Overall, blanket screening and selective screening both had similar lifetime costs and quality of life ratings, but screening only those at risk or with actual symptoms proved to be more cost effective in preventing bone loss and fractures among patients with undiagnosed or subclinical celiac disease. They noted that additional analyses looking at risk and cost of other potential consequences of undiagnosed and untreated celiac disease, such as anemia, infertility and malignancy, might change the cost-effectiveness balance more in favor of universal screening for celiac disease. Source: American Gastroenterological Association
  21. This article appeared in the Winter 2008 edition of Celiac.com's Scott-Free Newsletter. Celiac.com 12/20/2007 - Celiac disease is under-diagnosed because many celiac disease patients do not show classic gastrointestinal symptoms. Highly sensitive and specific serological tests have led to the diagnosis of celiac disease in patients for whom short stature may be the only obvious symptom. Researchers from Brazil and Italy have previously reported that celiac disease accounts for 1-5% of short stature in children. Prevalence of celiac disease varies widely according to geographic location. Although epidemiological studies are lacking in India, celiac disease reporting has increased exponentially due to targeted screening and better serological tests. To better understand the relationship between short stature and celiac disease, researchers from the Endocrine Clinic of the Postgraduate Institute of Medical Education and Research in Chandigarh studied children referred for a work-up of short stature from January 2005 to December 2006. Researchers enrolled 176 patients, half male and half female, who fit the criteria for short stature: height ≥ 2.5 standard deviations below the mean for chronological age, growth rate below the fifth percentile for chronological age, and height ≥ 2 standard deviations below mean for chronological age when corrected for mid-parental height. Most patients were 10-15 years old (mean age of 14.5). Researchers took detailed histories and carried out clinical evaluations and screening tests. If they could find no endocrine cause for short stature or if diarrhea had been present for more than 3 months, researchers estimated IgA anti-tissue transglutaminase antibodies (anti-tTG) and performed an endoscopic biopsy. Celiac disease was found in 27 (15.3%) of the patients, making it the single most common cause of short stature. 25 children had pituitary disorder (14%), 24 had hypothyroidism (14%), and constitutional delay of growth and puberty or familial short stature accounted for 18 (11%). Other less common causes of short stature were metabolic bone disease, Turner syndrome, adrenal disorders, diabetes mellitus, and nutritional deficiency. All celiac disease patients were positive for tTG antibodies and had a duodenal biopsy suggestive of celiac disease. All celiac disease patients were symptomatic; the most common symptoms after growth retardation were anemia (88%), weight loss (80%), diarrhea (69%), and delayed puberty (54%). The average time to diagnosis for these patients was 5.5 years (95% cI: = 2.5 to 8.5 years). The celiac disease patients were treated with a gluten-free diet, calcium (500 mg/day), vitamin D (300,000 U cholecalciferol once every 3 months), and iron and multivitamin supplementation including folic acid and vitamin B12. During the 6-9 month follow-up period, growth rate velocity increased significantly from 2.9 cm/year (95% cI = 2.41 to 3.39 cm/year) to 8.9 cm/year (95% cI = 6.7 to 11.1 cm/year). Celiac disease can lead to short stature by causing autoimmune hypothydroidism, resistance to growth hormones, and malabsorption of protein, calcium and vitamin D. Additionally, celiac disease can lead to hypogonadism which inhibits the pubertal growth spurt. Researchers recommend that all short children be screened for celiac disease. Resources Bhadada, S. Bhansali, A., Kochhar, R., Shankar, A., Menon, A., Sinha, S., Dutta, PP., and Nain, C. Does every short stature child need screening for celiac disease? Gastroenterology [OnlineEarly Articles]. doi:10.1111/j.1440-1746.2007.05261.x
  22. Celiac.com 08/09/2010 - Modern scientists agree that scientific evidence connects celiac disease with Type 1 Diabetes. What scientists fail to agree on is what to do about the connection between the two autoimmune diseases. Some scientists promote celiac screening for all patients with type 1 Diabetes, while other scientists disagree. Celiac disease and Type 1 Diabetes are similar in that they are both autoimmune disorders resulting from a combination of genetic predisposition and environmental factors. The occurrence of celiac disease in patients with Type 1 Diabetes is documented to have a ratio 5-7 times higher than the general public. Also noted is an increased prevalence rate within ethnic groups. Classic celiac disease symptoms can be seen in Type 1 Diabetes patients, although most celiac and Type 1 diabetics are found to have mild or no symptoms. In fact, a study at a North American celiac clinic examined children that had celiac and Type 1 Diabetes and showed that 71.4% of the subjects claimed to have no gastrointestinal symptoms at the time of their positive diagnosis. Another similar study in the United Kingdom reported that 76.4% of their patients studied exhibited at least one gastrointestinal symptom. In fact, the study goes on to state that when they further examined the Type 1 diabetics, 86% initially showed no symptoms but at the time of biopsy the percentage dropped to 22%. Serological testing has not only improved screening methods for celiac diagnosis, but also let to an increase in celiac diagnosis rates. In Canada for example, celiac disease prevalence has shown a threefold increase since 1996. Consensus-based celiac testing guidelines have been developed by many organizations, however, all of these organizations have a different idea of what to recommend to Type 1 diabetics when it comes to celiac screening and treatments. The North American Society for Pediatric Gastroenterology and Hepatology (NASPGHAN) suggests screening all Type 1 Diabetes patients for celiac disease and they encourage a gluten-free diet for asymptomatic children with other associated conditions. However HASPGHAN also recognizes that there isn't a lot of evidence supporting short-term improvements for diabetics on a gluten-free diet. The International Society for Pediatric and Adolescent Diabetes (ISPAD) agrees that there is limited data to support a gluten-free diet for diabetics. As such ISPAD refers children to a pediatric dietician if they test positive for celiac disease and Type 1 Diabetes. The National Institutes of Health promotes celiac screening for symptomatic Type 1 Diabetes patients, and they recommend treating patients that exhibit biopsy proven celiac disease. The American Diabetic Association (ADA) advocates screening all Type 1 Diabetes patients for celiac. They also urge patients with a confirmed celiac diagnosis to maintain a gluten-free diet. The Canadian Diabetes Association (CDA) promotes screening Type 1 Diabetes patients for celiac but they emphasize that treatment of asymptomatic celiac disease combined with Type 1 Diabetes is controversial. These conflicting instructions for screening and treating celiac are partly to blame the fact that most physicians are unclear about proper protocol for celiac diagnosis and treatment. With so many authorities offering conflicting advice, it's no wonder that many celiacs remain misdiagnosed or undiagnosed. It is also further evidence that a mandated approach to detecting and treating celiac disease is critical in order to avoid long term ramifications. Source: Int J Pediatr Endocrinol. 2010;2010:161285. Epub 2010 Jun 23.
  23. Celiac.com 12/13/2010 - Driven by the high prevalence of celiac disease, a team of researchers based in Italy to assess a new, noninvasive disease screening strategy that would allow them to make an early diagnosis of celiac disease in 6- to 8-year-old children. Timely diagnosis will help doctors to initiate a gluten-free diet in willing patients, achieve growth targets, and prevent celiac disease complications. For the study, the research team recruited 5000 subjects, and ultimately tested 4048 saliva samples for anti-tissue transglutaminase (tTG) and immunoglobulin (Ig)A using fluid-phase radioimmunoprecipitation. For children with positive samples, the team arranged follow-up screening by serum radioimmunoassay tTG IgA, enzyme-linked immunosorbent assay tTG IgA, and anti-endomysium IgA. Children with positive serum assays underwent endoscopy with duodenal biopsies, and researchers advised those diagnosed with celiac disease to start a gluten-free diet. The team gained screening consent from 4242 parents (84.8%), and obtained usable saliva samples from a total of 4048 children (95.4%). Thirty-two children showed positive salivary tTG IgA, with another nine showing borderline autoantibody results. Thirty-one of the 32 tTG IgA-positive subjects, and three of the nine borderline subjects also had positive blood screens. Intestinal biopsy showed twenty-eight children with villous atrophy, while one child showed Marsh 1 lesions. The research team recommended a gluten-free diet to three children without performing endoscopy. This makes for a celiac disease rate of 1.16% in the study population, including 19 known cases of celiac disease. The results show that screening detected three cases of celiac disease for every two cases diagnosed before screening was 3:2. The ratio between symptomatic and asymptomatic patients was 1:1.6. The study shows that saliva screens for celiac disease can be effective in identifying celiac disease early in childhood. Also, for this study at least, the data shows full compliance with gluten-free diet in the children diagnosed with celiac disease. Source: Journal of Pediatric Gastroenterology & Nutrition 3 November 2010. doi: 10.1097/MPG.0b013e3181e6f2d0
  24. Celiac.com 08/27/2012 - Because so many patients are now overweight upon diagnosis for celiac disease, and so fee present as classically underweight, doctors are revising the clinical presentation guidelines for celiac disease diagnosis. That being said, some researchers have voiced concern that some patients might gain further weight while on a gluten-free diet. Recently, a team of researchers conducted a study to assess the impact of a gluten-free diet on body mass index (BMI) in a nationwide group of celiac patients and to isolate any variables that might help to predict favorable or unfavorable BMI changes. The research team included Anniina Ukkola, Markku Mäki, Kalle Kurppa, Pekka Collin, Heini Huhtala, Leila Kekkonen, and Katri Kaukinen. They are affiliated variously with the School of Medicine, University of Tampere, and the Department of Gastroenterology and Alimentary Tract Surgery at Tampere University Hospital, both in Tampere, Finland. To assess weight and disease-related issues, the researchers looked at 698 newly detected adults who were diagnosed with celiac disease by classical or extra-intestinal symptoms or by screening. The researchers measured BMI upon celiac diagnosis and after one year on a gluten-free diet. They then compared the results against data for the general population. Study data showed that 4% of patients were underweight at celiac diagnosis, 57% were normal weight, 28% were overweight and 11% were obese. On a gluten-free diet, 69% of underweight patients gained weight, while 18% of overweight and 42% of obese patients lost weight. BMI remained stable for the other patients. Both symptom- and screen-detected celiac patients showed similar results. The patients with celiac disease showed a more favorable BMI pattern than the general population. The most favorable BMI changes were seen in patients with self-rated gluten-free diet expertise, along with those who were younger upon diagnosis. Dietary counseling did not seem to impact . The initial method of detection does not seem to matter for people with celiac disease who are following a gluten-free diet. Both screen-detected and symptom-detected celiac disease patients who followed a gluten-free diet showed similar improvements in body mass index (BMI). Source: European Journal of Internal Medicine Volume 23, Issue 4, Pages 384-388, June 2012
  25. Celiac.com 01/16/2012 - Should there be mass screening for celiac disease? Currently, there is no consensus among scientists or among public policy makers in favor of mass screening for celiac disease as a public health intervention. Advocacy for mass celiac disease screening remains somewhat controversial. A team of researchers recently conducted a mixed-method study to address the issue of mass screening for celiac disease from the perspective of newly diagnosed patients and their parents. The study team included Anna Rosén; Maria Emmelin; Annelie Carlsson; Solveig Hammarroth; Eva Karlsson, and Anneli Ivarsson. The team screened data from a total of 145 people with antibody-detected celiac disease. They got the data from a Swedish school-based screening study. They then invited the adolescents with celiac disease and their parents to join this study about one year after diagnosis. In all, the team conducted 14 focus group discussions with 31 adolescents and 43 parents. They obtained written narratives from 91 adolescents (63%) and 105 parents (72%), and obtained full questionnaires from 114 parents (79%). They then analyzed data using qualitative content analysis. They were able to use narratives and questionnaire data for quantified measures. They found that the majority of adolescents and parents described how they agreed to participate "for the good of others," without concern for themselves. Many found the invitation "hard to resist," since it introduced the possibility that they might have the disease. The majority who were diagnosed described the experience as "a bolt of lightning," but for many others, diagnosis offered an explanation for previous health problems. Many of those people describe how "suddenly everything made sense," once they were diagnosed. Participants largely reported "feeling grateful for being made aware," of their celiac disease, but some adolescents and parents also reported "ambivalent feelings about personal benefits." 92% of parents supported future screening for celiac disease. The most common opinion among most adolescents and parents agreeing that mass screening should be "a right for everyone" and should be offered as early as possible. Though most people diagnosed with celiac disease were surprised, adolescents and parents reported feeling grateful for the diagnosis. Most kids with celiac disease and their parents participating in the study said that they welcomed mass screening for celiac disease, but suggested that it should be done earlier in life. Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3229548/
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