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Found 8 results

  1. Hi everyone, Back story: I was diagnosed with a borderline wheat allergy as a toddler, but the same allergist told my mother that spelt and Kamut (types of wheat) were ok to feed me. So, I have no idea how reputable that doctor was, and I’ve been eating wheat most of my life. I’ve got tons of issues because of it, and recently went to a gastroenterologist familiar with celiac to see if I needed to worry about complications developing or anything like that. He said I needed to do the gluten challenge and serology testing to find out whether I have Celiac, or gluten sensitivity with some other condition, before he could move forward. After much deliberation, I decided to do the gluten challenge, and I am currently two weeks in. I am miserable, worried it’s affecting my job stability, and struggling to get through my days. The doctor told me I could do the gluten challenge for a minimum of two weeks, but that I should really do it for a month if I can. I can’t. I’m going to try and get through a third week and then give up. Question: The doctor’s nurse told me to go in for the blood test 4 weeks after I stop the gluten challenge. I can’t find anything about waiting any length of time between the challenge and the serology. Does anyone have experience with this or know anything about that waiting period? Thanks for your time, Cassandra
  2. 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
  3. Celiac.com 02/13/2014 - A team of researchers recently set out to assess the validity and effectiveness of near-patient celiac immunological testing in dietician-led celiac disease follow-up clinics, and to compare the results against standard laboratory immunological techniques. The research team included D.A. George, L.L. Hui, D. Rattehalli, T. Lovatt, I. Perry, M. Green, K. Robinson, J.R.F. Walters, and M.J. Brookes. They are variously affiliated with the Department of Gastroenterology at New Cross Hospital in Wolverhampton, and the Department of Gastroenterology at Imperial College London, in London, UK. Each of the two phases of the study assessed the near-patient test and standard laboratory immunological techniques. In Phase 1, the team analyzed stored serum samples, while in Phase 2 they analyzed whole blood from patients attending the dietician-led celiac disease clinics. Between March 2010 and February 2011, the team recruited 50 patients from New Cross Hospital, Wolverhampton, and 30 from Imperial College London. All patients had a diagnosis of celiac disease for greater than 12 months, and attended dietician-led celiac disease clinics. During the study, the team took whole blood samples for routine analysis, along with regular capillary finger-prick blood samples. The team wanted to determine if the whole blood and serum near-patient test results correlated with outcomes of standard laboratory evaluation. The first phase of the study showed that the near-patient serum test had a sensitivity of 93.5% (95% CI 0.79% to 0.98%), and a specificity of 94.9% (0.83% to 0.99%), when compared with the standard laboratory ELISA. The second phase showed that whole blood measurements had a sensitivity of 77.8% (0.45% to 0.93%), and specificity of 100% (0.94% to 1%). The team concludes that the study results suggest a possible role for near-patient testing in celiac disease, but they suggest additional studies to corroborate and refine such a role. Disclosure: The team noted the receipt of a £2250 (approximately $3,750.00) bursary award from Dr. Falk Pharma and Core. Source: Frontline Gastroenterol. 2014;5(1):20-25.
  4. Celiac.com 08/12/2011 - Although serological analysis is used in diagnosing celiac disease, histopathology is regarded as most reliable. A team of researchers set out to assess the clinical, pathological and serological spectrum of celiac disease in a general population via prospective study (Kalixanda study). The research team included Marjorie M. Walker, Joseph A. Murray, Jukka Ronkainen, Pertti Aro, Tom Storskrubb, Mauro D’Amato, Brian Lahr, Nicholas J. Talley, and Lars Agreus. For their study, the team evaluated a random sample of 1000 adults from the general population by upper endoscopy, duodenal biopsy, and serological analysis of tissue transglutaminase (tTg) levels. They screened samples that were tTg+ for endomysial antibody (EMA) levels. The baseline value for celiac diagnosis was villous atrophy with 40 intraepithelial lymphocytes (IELs)/100 enterocytes (ECs). The team found 33 subjects with tTg+ and 16 with EMA+. Their histological analysis showed 7/1000 subjects (0.7%) with celiac disease, all of whom showed tTg+ and 6 of 7 of whom showed EMA+. Another 26 subjects showed tTg+, 7 of 26 showing EMA+. The team then addressed these cases with a second quantitative pathology study, this one a nested case-control design, that used a celiac diagnosis baseline of 25 IELS/100 ECs. Under this criteria, all 13 samples that were tTg+ and EMA+ had more than 25 IELs/100ECs. A total of 16 subjects (1.6%) showed serological and histological evidence of gluten-sensitive enteropathy. The team quantified IELs in duodenal biopsy samples from 500 seronegative individuals. A total of 19 (3.8%) of those subjects had >25 IELs and lymphocytic duodenosis (LD). A celiac diagnosis level of ≥25 IELs/100 ECs was strongly associated with serological indicators of celiac disease, while a higher IEL threshold missed half of cases. Quantification of tTg is a sensitive test for celiac disease, and diagnosis can be confirmed by observation of ≥25 IELs/100ECs in duodenal biopsy. Lymphocytic enteropathy in the form of both celiac disease and Lymphocytic duodenitis, is common, occurring in about 5.4% of the general population. Source: Gastroenterology doi: 10.1053/j.gastro.2010.04.007
  5. Celiac.com 06/19/2009 - Specialty pharmaceutical and diagnostic company, Prometheus Laboratories Inc., announced results from two recent studies concerning the use of serologic testing to predict inflammatory bowel disease (IBD). The first study assessed the consistency of biomarkers in patients who received multiple Prometheus IBD Serology 7 tests within a two-year period. Overall levels for repeat testing orders were just 2.2%. Original and repeat tests showed a high degree of agreement. Average variation in biomarker serum concentrations ran between 2.2 EU/mL and 4.3 EU/mL. Results agreed with prior studies suggesting biomarker stability over similar time periods. Further studies are needed to gauge the impact of therapy on biomarker stability over the long term. A second, multi-center clinical study of 1,574 subject samples brought the total development cohort of the test to a more heterogeneous 3,626 patient samples. Results with this large patient cohort further showed that combining multiple markers with Prometheus' Smart Diagnostic Algorithm permits clinicians to better distinguish IBD vs. non-IBD and Crohn's disease vs. ulcerative colitis, compared to standard cutoff value analysis of the individual markers alone. Prometheus IBD Serology 7 combines multiple serologic markers with a proprietary Smart Diagnostic Algorithm, increasing test sensitivity by more than 25% over single marker sensitivity values. Source: Medical News Today
  6. There are different practices amongst GIs on repeat biopsies vs. serology, and on gluten challenges. My sons g/i, for example, took the position that since my sons symptoms stopped on a gluten-free diet, and his previously sky-high EMA and ARA went back to normal, that it was unnecessary to do either a repeat biopsy or a gluten challenge. From the celiac list correspondence, I now see that my GI is rather liberal.** Vijay Kumar, M.D., Research Associate Professor at the University of Buffalo and President and Director of IMMCO Diagnostics: I think your sons GI is doing the right thing. That is, if the EMA, ARA are normal (
  7. Vijay Kumar, M.D., Research Associate Professor at the University of Buffalo and President and Director of IMMCO Diagnostics: It is important for the serum tests to be negative in patients with celiac disease. These tests provide strong indicators that the gluten free diet followed is effective and is free of gluten. Sometimes drugs or other intakes may be contaminated with gluten that may continue sensitization and the disease process which may be subclinically. We and others believe once the diagnosis of celiac disease is confirmed and the patient is on a gluten free diet, repeat tests once in 3-6 months may be sufficient. Karoly Horvath, M.D., Ph.D., Associate Professor of Pediatrics; Director, Peds GI & Nutrition Laboratory; University of Maryland at Baltimore: If a patient has histologically (endoscopy) and serologically (antibody tests) proved celiac disease, and his/her symptoms disappeared on a gluten-free diet, a repeat biopsy is not necessary. The serological tests are useful tools for estimating the effectiveness of the diet after 3-6 months on a gluten-free diet. The disappearance of antibodies from the blood takes months, if there was not any accidental gluten challenge (dietary mistake).
  8. Vijay Kumar, M.D., Research Associate Professor at the University of Buffalo and President and Director of IMMCO Diagnostics: Not really. It is not true that the serological methods have lower predictive value in children less than two years of age. In all the studies that we did, there was 100% correlation of the EMA to the disease activity irrespective of the age. Karoly Horvath, M.D., Ph.D., Associate Professor of Pediatrics; Director, Peds GI & Nutrition Laboratory; University of Maryland at Baltimore: There are age dependent changes in several blood parameters during childhood. It is well known that immunoglobulin levels depend on the age of children. E.g. the IgA class immunoglobulins reach the adult level only by 16 years of age, and the blood level of IgA immunoglobulins is only 1/5th of adult value below two years of age. A large study from Europe (Brgin-Wollf et al. Arch Dis Child 1991;66:941-947) showed that the endomysium antibody test is less specific and sensitive in children below two years of age. They found that the sensitivity of the EmA test decreased from 98% to 88% in children younger than 2 years of age. It means that 12% of their patients with celiac disease, who were younger than two years of age, did not have an increase in their endomysium antibody levels.
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