Hyperimmunoglobulin a and celiac disease in the elderly.
Journal of the American Geriatrics Society (Impact Factor: 3.98). 07/2005; 53(6):1074-5. DOI:10.1111/j.1532-5415.2005.53338_2.x
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ABSTRACT: To evaluate the impact of a 1-year gluten-free diet on bone metabolism and nutritional status in coeliac disease. Bone mineral density, serum indices of bone remodelling, clinical and biochemical nutritional assessment were evaluated in 86 consecutive newly-diagnosed, biopsy proven, coeliac disease patients (untreated). A complete reevaluation, including intestinal biopsy, was repeated within 1 year of dietary treatment (treated). Untreated: according to WHO criteria, 34% of patients had a normal bone mineral density, 40% had osteopenia and 26% osteoporosis. Between males and females there were no statistical differences in bone metabolism or in most of the nutritional indices, while, between fertile and postmenopausal women, bone mineral density and several bone metabolism markers were significantly different. Compared to subjects with a normal bone mineral density, osteopenics had higher bone specific alkaline phosphatase (BAP) and Bone-Gla-protein (BGP) values. In patients with a concomitant BAP increase and 25OH vitamin D serum level reduction, bone mineral density and several bone turnover markers were statistically different compared to patients without such a serological pattern. Treated: notwithstanding intestinal biopsy which showed a mucosal recovery in only 57%, gluten-free diet led, even in postmenopausal women, to a significant improvement in bone mineral density, bone metabolism and nutrition, except for folic acid, albumin and pre-albumin serum levels which persisted as abnormal in patients with obdurate mucosal impairment. Coeliac disease patients are at high risk for developing a low bone mineral density and bone turnover impairment. A gluten-free diet can improve this situation even in postmenopausal women and in patients with incomplete mucosal recovery.Alimentary Pharmacology & Therapeutics 02/2000; 14(1):35-43. · 4.55 Impact Factor
Article: Coeliac disease in the elderly.[show abstract] [hide abstract]
ABSTRACT: Of 228 patients with adult coeliac disease, 42 (19%) were diagnosed aged 60 years or over. In this series, of 35 patients who did not have dermatitis herpetiformis, 15 had attended family doctors and hospital outpatient departments for an average of 28 years with unexplained symptoms or abnormalities in blood tests but the diagnosis of coeliac disease had been missed. This is unsatisfactory because these patients can both manage and respond to a gluten free diet. Thirty eight patients complied strictly with the diet with resolution of symptoms. Significant improvement in weight, haemoglobin, albumin, calcium, and alkaline phosphatase values after a year on the diet also occurred. Clinicians should be alert to the possibility of coeliac disease in the elderly particularly in patients with non-specific complaints in the presence of unexplained anaemia.Gut 02/1994; 35(1):65-7. · 10.73 Impact Factor
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ABSTRACT: Serum-levels of IgG, IgA, IgM, and Summary IgD have been determined in 110 patients with adult cœliac disease and compared with levels in 152 healthy controls. Significant increases in IgA were found, and these seem to be related to the quantity of gluten ingested and, in some patients, to milk sensitivity. 3 patients with progressive increase in IgA values developed gastrointestinal lymphoma. Significantly low IgG and IgM values were also noted; there was little change on gluten withdrawal.The Lancet 08/1969; 2(7612):129-31. · 39.06 Impact Factor
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