A difficult diagnosis of coeliac disease: Repeat duodenal histology increases diagnostic yield in patients with concomitant causes of villous atrophy

Morreale, Gaetano Cristian; Montalbano, Luigi; Cappello, Maria; Sinagra, Emanuele; Rizzo, Aroldo; Carroccio, Antonio

doi:10.1016/j.ajg.2017.09.011

Cited by 5 publications

(5 citation statements)

References 24 publications

(35 reference statements)

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“…This retrospective study was conducted on a group of 59 children hospitalized with CD over three years (2016–2018). The patients with concomitant diseases that could be a cause of villous atrophy were excluded from the analysis [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

Immunogloboulin E-Mediated Food Sensitization in Children with Celiac Disease: A Single-Center Experience

Cudowska

Lebensztejn

2021

Pediatr Gastroenterol Hepatol Nutr

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Purpose Celiac disease (CD) is an autoimmune disorder of the small intestine caused by an abnormal immune response to gluten proteins and is often characterized by gastrointestinal symptoms. Food allergy (FA) is an adverse immune sensitivity to ingested food proteins leading to inflammation in various organs including the gastrointestinal tract. The relationship between CD and FA remains unclear. This study aimed to assess the prevalence and clinical relevance of immunoglobulin E (IgE)-mediated food sensitization in children with CD. Methods Fifty-nine children diagnosed with CD were reviewed for clinical symptoms and evidence of IgE-sensitization to food and airborne allergens using the PolyCheck method. Results IgE-mediated sensitization has been diagnosed in 20.3% of children with CD (CD/ A). In the CD/A group, 58.3% of children were sensitized to food and 66.7% to airborne allergens. Further, 41.7% of patients with CD and allergy reported gastrointestinal tract symptoms associated with the ingestion of sensitizing foods. Analysis of the clinical status revealed that the incidence of other allergic disorders in the CD/A group was as follows: atopic dermatitis (33.3%), asthma (25.0%), and allergic rhinitis (16.7%). The percentage of eosinophils was significantly higher in the CD/A group than in the CD group (0.33±0.25 vs. 0.11±0.09; p =0.006). Conclusion The diagnosis of CD does not exclude FA. The gastrointestinal symptoms in children with CD may be the result of both CD and FA; therefore, children with CD should be evaluated for the presence of FA regardless of age.

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Section: Methodsmentioning

confidence: 99%

Immunogloboulin E-Mediated Food Sensitization in Children with Celiac Disease: A Single-Center Experience

Cudowska

Lebensztejn

2021

Pediatr Gastroenterol Hepatol Nutr

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“…Gastrointestinal symptoms are frequent in CVID (up to 60% of cases) 1 9. Crohn’s disease-like findings, as lymphoid nodular hyperplasia, villous atrophy, crypt hypertrophy and a T-lymphocyte infiltrate have been described 9. As previously stated by Morreale et al ,9 in patients with CVID an alteration of the duodenal mucosa poses a difficult differential diagnosis that includes celiac disease.…”

Section: Discussionmentioning

confidence: 93%

“…Crohn’s disease-like findings, as lymphoid nodular hyperplasia, villous atrophy, crypt hypertrophy and a T-lymphocyte infiltrate have been described 9. As previously stated by Morreale et al ,9 in patients with CVID an alteration of the duodenal mucosa poses a difficult differential diagnosis that includes celiac disease. The diagnostic dilemma is that CVID and celiac disease may coexist in the same patient, associated with the fact that patients with CVID do not have an antibody response which means they are seronegative for celiac disease.…”

Section: Discussionmentioning

confidence: 93%

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Gluten-free diet: a possible treatment for chronic diarrhoea in common variable immunodeficiency

Pita¹,

Fernandes

Almeida

et al. 2018

BMJ Case Reports

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Gastrointestinal disorders are frequent in common variable immunodeficiency (CVID). Clinical symptoms and histological alterations in CIVD can resemble celiac disease. Usually, patients with chronic diarrhoea associated with CVID do not improve with a gluten-free diet. The authors present a case of a male patient who was diagnosed with CVID at age 33 and had chronic diarrhoea which resolved after initiating a gluten-free diet. Clinical relapse occurred after gluten reintroduction. The main objective of this case report is to alert clinicians to implement a gluten-free diet in patients with CVID with chronic diarrhoea.

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“…Clinical manifestations of CD are wide-ranging from intestinal symptoms to non-intestinal symptoms (Roshanzamir et al, 2021), however, most of the patients exhibit intestinal problems (Lebwohl et al, 2018). Usually, diagnosis of CD is based on the titer of IgA anti-transglutaminase antibodies (IgA anti-tTG) and endoscopic ndings (Saadah et al, 2020, Morreale et al, 2017. Confocal endomicroscopy can also be used for the diagnosis of CD (Meriam et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Association of rs6441961 with celiac disease patients from Punjabi Pakistani population

Ali

Khan

Hussain

et al. 2022

Preprint

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Celiac disease (CD) is well known for chronic inflammation of intestine due to the gluten intolerance. Various environmental and genetic factors are responsible for CD pathogenesis. Studies have shown that polymorphisms in C-C chemokine receptor type 3 encoding CCR3 gene are important in onset and progression of CD owing to its prominent role in promoting allergic reactions and other CD-related complications. Various studies have shown that CCR3 rs6441961 T > C polymorphism significantly increases the risk of CD. Thus, the objectives of current study were to genotype the rs6441961 by using cost efficient and rapid genotyping assay, assess its prevalence in Punjabi Pakistani population and to check its association with celiac disease. Total 90 subjects were recruited and divided into two groups [healthy controls (N = 55) and patient group (N = 35)]. Tetra-ARMS-PCR was designed, optimized and used for quick, specific and less expensive genotyping of rs6441961. Chi-square test and logistic regression analysis were applied to check the association of rs6441961 with CD. Statistical analysis revealed that TT and TC genotypes were more prevalent in both groups, however, the prevalence of CC genotype was more in patient group as compared to healthy controls (25.8% vs. 18.2%). In spite of these differences, they could not reach the significance level (χ2 = 0.74, p = 0.69). Multinomial regression analysis also complimented the findings of chi-square test. In summary, in-house developed tetra-ARMS-PCR is rapid, accurate and cost effective. TT genotype is more prevalent in Punjabi Pakistani population. The risk of CD in Punjabi Pakistani population is not influenced by CCR3 rs6441961 T > C polymorphism.

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A difficult diagnosis of coeliac disease: Repeat duodenal histology increases diagnostic yield in patients with concomitant causes of villous atrophy

Cited by 5 publications

References 24 publications

Immunogloboulin E-Mediated Food Sensitization in Children with Celiac Disease: A Single-Center Experience

Immunogloboulin E-Mediated Food Sensitization in Children with Celiac Disease: A Single-Center Experience

Gluten-free diet: a possible treatment for chronic diarrhoea in common variable immunodeficiency

Association of rs6441961 with celiac disease patients from Punjabi Pakistani population

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