At-Risk Screened Children with Celiac Disease are Comparable in Disease Severity and Dietary Adherence to Those Found because of Clinical Suspicion: A Large Cohort Study

Kivelä, Laura; Kaukinen, Katri; Huhtala, Heini; Lähdeaho, Marja–Leena; Mäki, Markku; Kurppa, Kalle

doi:10.1016/j.jpeds.2016.12.077

Cited by 39 publications

(47 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…171 Asymptomatic children have not shown reduced adherence to a GFD. 172 The additional diagnosis in children with type 1 diabetes may have a minimal effect on the quality of life of the child, although non-adherence may negatively influence quality of life as well as metabolic control. 173 Children and adolescents with both type 1 diabetes and celiac disease are at increased risk for microvascular complications.…”

Section: Celiac Diseasementioning

confidence: 99%

“…Improved understanding of the diet as well as access to a dietitian and regular follow up may assist adherence . Asymptomatic children have not shown reduced adherence to a GFD . The additional diagnosis in children with type 1 diabetes may have a minimal effect on the quality of life of the child, although non‐adherence may negatively influence quality of life as well as metabolic control …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

ISPAD Clinical Practice Consensus Guidelines 2018: Nutritional management in children and adolescents with diabetes

et al. 2018

View full text Add to dashboard Cite

Section: Celiac Diseasementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

ISPAD Clinical Practice Consensus Guidelines 2018: Nutritional management in children and adolescents with diabetes

et al. 2018

View full text Add to dashboard Cite

“…Although HLA-DQ2 variant is required for the gluten-derived peptide gliadin presentation to T-cells, non-HLA genetic factors account for the majority of heritable risk [1] and for the predisposition of CD patients to develop other disorders [2, 3]. …”

Section: Introductionmentioning

confidence: 99%

“…Indeed, IDA is often recorded in newly diagnosed CD [3, 4] and may persist for variable periods after initiation of a gluten-free diet [5]. IDA may complicate well-established CD, but may also be the presenting clinical feature in the absence of classical symptoms such as diarrhea or weight loss [6–8].…”

Section: Introductionmentioning

confidence: 99%

The DMT1 IVS4+44C>A polymorphism and the risk of iron deficiency anemia in children with celiac disease

et al. 2017

View full text Add to dashboard Cite

BackgroundIron deficiency anemia in celiac disease is related to impaired duodenal mucosal uptake, due to villous atrophy. Iron enters the enterocytes through an apical divalent metal transporter, DMT1. Different DMT1 transcripts have been identified, depending on the presence of an iron-responsive element that allows DMT1 up-regulation during iron starvation. An intronic DMT1 polymorphism, IVS4+44C>A, has been associated with metal toxicity, and the CC-carriers show high iron levels.AimsThis study investigates the association between DMT1 IVS4+44C>A and anemia in a cohort of 387 Italian celiac children, and the functional role of the polymorphism.Methods and resultsBy association analysis, we found that DMT1 IVS4+44-AA genotype confers a four-fold risk of developing anemia, despite of atrophy degree. By analysis of mRNA from gastroesophageal biopsies, we found that total DMT1 is significantly upregulated in presence of mild, but not severe, atrophy, independently from IVS4+44C>A variant, and in normal but not in atrophic CC-biopsies. Moreover, we found that A-allele is associated to preferential expression of the DMT1 transcripts lacking the iron-responsive element, thus limiting the DMT1 overexpression that normally occurs to respond to iron starvation.DiscussionPossibly, the IVS4+44-AA-related dysregulation of the iron-induced changes in DMT1 expression is not able to impair iron absorption in physiological condition. However, if exacerbated by the concomitant massive loss of functional absorbing tissue paralleling worsened stages of villus atrophy, it might be ineffective in counteracting iron deficiency, despite of DMT1 overexpression.ConclusionWe suggest, for the first time, that celiac disease may unmask the contribution of the DMT1 IVS4+44C>A polymorphism to the risk of anemia.

show abstract

“…The Concept of the Celiac Iceberg CD screening studies have clearly shown that the percentage of cases that are diagnosed clinically (the visible part of the iceberg) is much smaller than the overall CD prevalence (the submerged CD iceberg). The clinical severity of those detected in regular clinical care and those detected by screening, does not, however, seem to differ (29). In countries showing a high level of awareness of the CD clinical spectrum, still 50-75% of cases remain undiagnosed and are therefore exposed to the risks of long-term complications.…”

Section: Prevalence Of CD On a Worldwide Basismentioning

confidence: 93%

Recent Progress and Recommendations on Celiac Disease From the Working Group on Prolamin Analysis and Toxicity

et al. 2020

View full text Add to dashboard Cite

Celiac disease (CD) affects a growing number of individuals worldwide. To elucidate the causes for this increase, future multidisciplinary collaboration is key to understanding the interactions between immunoreactive components in gluten-containing cereals and the human gastrointestinal tract and immune system and to devise strategies for CD prevention and treatment beyond the gluten-free diet. During the last meetings, the Working Group on Prolamin Analysis and Toxicity (Prolamin Working Group, PWG) discussed recent progress in the field together with key stakeholders from celiac disease societies, academia, industry and regulatory bodies. Based on the current state of knowledge, this perspective from the PWG members provides recommendations regarding clinical, analytical and legal aspects of CD. The selected key topics that require future multidisciplinary collaborative efforts in the clinical field are to collect robust data on the increasing prevalence of CD, to evaluate what is special about gluten-specific T cells, to study their kinetics and transcriptomics and to put some attention to the identification of the environmental agents that facilitate the breaking of tolerance to gluten. In the field of gluten analysis, the key topics are the precise assessment of gluten immunoreactive components in wheat, rye and barley to understand how these are affected by genetic and environmental factors, the comparison of different methods for compliance monitoring of gluten-free products and the development of improved reference materials for gluten analysis.

show abstract

At-Risk Screened Children with Celiac Disease are Comparable in Disease Severity and Dietary Adherence to Those Found because of Clinical Suspicion: A Large Cohort Study

Cited by 39 publications

References 48 publications

ISPAD Clinical Practice Consensus Guidelines 2018: Nutritional management in children and adolescents with diabetes

ISPAD Clinical Practice Consensus Guidelines 2018: Nutritional management in children and adolescents with diabetes

The DMT1 IVS4+44C>A polymorphism and the risk of iron deficiency anemia in children with celiac disease

Recent Progress and Recommendations on Celiac Disease From the Working Group on Prolamin Analysis and Toxicity

Contact Info

Product

Resources

About