Celiac disease

Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, USA.
Missouri medicine 01/2009; 106(5):346-50.
Source: PubMed


Celiac disease is a malabsorptive disorder resulting from intolerance to gluten and leads to systemic problems due to nutritional deficiencies. Enhanced diagnostic ability through serology has led to the understanding that it is more common than previously thought and often presents in atypical and subclinical forms. Clinicians must recognize the subtle presentations that may represent celiac disease, as well as at-risk populations, so that appropriate measures can be taken to diagnose and treat the disorder.

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    • "Most frequently, CD presents with gastrointestinal symptoms; however, it may be also associated with extraintestinal signs and symptoms and in women with reproductive disorders [9, 10]. CD has been associated with recurrent spontaneous abortion [10–20], intrauterine growth restriction, preterm delivery and low-birth weight [11–14, 16–27], infertility, delayed menarche, early menopause, and stillbirth [11, 28–32]. "
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    ABSTRACT: Celiac disease (CD) is a chronic autoimmune illness triggered by gluten consumption in genetically predisposed individuals. Worldwide, CD prevalence is approximately 1%. Several studies suggest a higher prevalence of undiagnosed CD in patients with infertility. We described reproductive disorders and assessed the frequency of hospital admissions for infertility among celiac women aged 15-49. We conducted two surveys enrolling a convenient sample of celiac women, residing in Apulia or in Basilicata (Italy). Moreover, we selected hospital discharge records (HDRs) of celiac women and women with an exemption for CD, and matched the lists with HDRs for reproductive disorders. In the surveys we included 91 celiac women; 61.5% of them reported menstrual cycle disorders. 47/91 reported at least one pregnancy and 70.2% of them reported problems during pregnancy. From the HDRs and the registry of exemption, we selected 4,070 women with CD; the proportion of women hospitalized for infertility was higher among celiac women than among resident women in childbearing age (1.2% versus 0.2%). Our findings highlight a higher prevalence of reproductive disorders among celiac women than in the general population suggesting that clinicians might consider testing for CD women presenting with pregnancy disorders or infertility.
    05/2014; 2014:614269. DOI:10.1155/2014/614269
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    • "anemia, osteoporosis, short stature, arthritis, infertility, peripheral neuropathy and dermatitis herpetiformis) [1-5]. A complete resolution of the clinical manifestations and of the intestinal mucosal lesions is obtained if a gluten-free diet is adopted [6]. However, CD is still heavily underdiagnosed, approximately 75-90% of the celiac population in western countries remains unrecognized, presumably due to the absence, or the atypical nature of symptoms, but also as a consequence of the poor physician awareness of the clinical spectrum of the disease [7,8]. "
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    ABSTRACT: Celiac disease (CD) is a chronic autoimmune illness of the small intestine triggered by gluten consumption in genetically predisposed individuals. CD presentation is not limited to the gastrointestinal tract and it is still under-diagnosed. Complete resolution of clinical manifestations follows if a gluten-free diet is adopted. In western countries, CD prevalence is approximately 1%. Age of onset is often between 6 months and 7 years.We assessed the approach to diagnosis and management of celiac patients by the paediatricians in Puglia Region, Italy. We conducted a cross-sectional survey among the 589 Apulian Family Paediatricians (FPs) during January 2011-January 2012 using a self-administered web-based standardized questionnaire including self-assessment of their knowledge, diagnostic path and type of management they would follow for CD, clinical information on their celiac patients. We assessed associations among the explored variables by defining double-entry contingency tables and calculating Odds Ratio (OR) with 95% Confidence Intervals (CIs). The 218 (37%) FPs participating in the study reported 1,020 CD patients (representing approximately 1% of the child population covered by the enrolled FPs). Of them, 55% were female; 45% were aged 5-10 years. Weight loss and stunting were the main reported symptoms at diagnosis (41%). The majority (98%) of FPs requested anti-transglutaminase antibody (tTG-Ab) titres for CD diagnosis. Approximately 78% of FPs recommended gluten introduction in the diet of infants at the age of 6 months; 12% and 8% recommended introduction of gluten before and after 6 months of age respectively.The degree of knowledge for either CD diagnosis making process or CD related diseases was medium/high in 97% and 82% of the participating FPs respectively. FPs (83%) who had a medium or high degree of knowledge of CD patients' diet were more likely to experience low or no difficulty in providing their patients with dietary advices (OR:5.5; 95%CI:1.7-17.5). Apulian FPs report a good degree of knowledge of CD, its diagnosis and its management. We will diffuse results and recommendations to all paediatricians in the Region. Actions aiming to continued education on CD in medical under and postgraduate trainings are crucial to prevent under-diagnosis.
    BMC Gastroenterology 02/2014; 14(1):38. DOI:10.1186/1471-230X-14-38 · 2.37 Impact Factor
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    • "In genetically predisposed subjects, exposure to gluten results in a mucosal damage which, progressing through different stages of severity, causes small-intestinal mucosal atrophy. A diet completely free of the above cereals results in the total resolution of the clinical picture as well as in complete healing of jejunal mucosa histological lesions [1]. "
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    ABSTRACT: The aim of this study is to explore the association between celiac disease and menstrual cycle, gestation and puerperal disorders. The association between celiac disease and menstrual cycle, gestation and puerperal disorders in a sample of 62 childbearing age women (15-49 age) was assessed within an age and town of residence matched case-control study conducted in 2008. Main outcome measures were the presence of one or more disorders in menstrual cycle and the presence of one or more complication during pregnancy. 62 celiac women (median age: 31.5, range: 17-49) and 186 healthy control (median age: 32.5, range: 15-49) were interviewed. A higher percentage of menstrual cycle disorders has been observed in celiac women. 19.4% frequency of amenorrhea was reported among celiac women versus 2.2% among healthy controls (OR = 33, 95% CI = 7.17-151.8;, p = 0.000). An association has been observed between celiac disease and oligomenorrhea, hypomenorrhea, dysmenorrhea and metrorrhagia (p < 0.05). The likelihood of having at least one complication during pregnancy has been estimated to be at least four times higher in celiac women than in healthy women (OR = 4.1, 95% CI = 2-8.6, p = 0.000). A significant correlation has emerged for celiac disease and threatened abortion, gestational hypertension, placenta abruption, severe anaemia, uterine hyperkinesia, intrauterine growth restriction (p < 0.001). A shorter gestation has on average been observed in celiac women together with a lower birth weight of celiac women babies (p < 0.001). The occurrence of a significant correlation between celiac disease and reproductive disorders could suggest to consider celiac disease diagnostic procedures (serological screening) in women affected by these disorders.
    BMC Gastroenterology 08/2010; 10(1):89. DOI:10.1186/1471-230X-10-89 · 2.37 Impact Factor
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