Celiac Disease in Women With Infertility

Singh, Prashant; Arora, Shubhangi; Lal, Sunil K.; Strand, Tor A.; Makharia, Govind

doi:10.1097/mcg.0000000000000285

Cited by 49 publications

(35 citation statements)

References 39 publications

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“…When making a diagnosis of CD, it is very important to know if the patient suffers from the different symptoms; since studies that diagnose CD are invasive analyses [4,5,9,10,20,22,24,26,27,[30][31][32]37,39,41,43,45,46,[49][50][51]58]. Therefore, before requesting the analyses, it is useful to perform a Celiac Symptom Index test to identify the symptoms apart from the clear use of the clinical history; in this way, a better diagnosis can be made [57].…”

Section: Discussionmentioning

confidence: 99%

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Tools Used to Measure the Physical State of Women with Celiac Disease: A Review with a Systematic Approach

Martínez-Rodríguez

Loaiza-Martínez

Sánchez-Sánchez

et al. 2020

IJERPH

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Celiac disease (CD) is an immunological disorder that mainly affects the small intestine, generating an inflammatory process in response to the presence of gluten (a protein). Autoimmune diseases are part of a group of diseases that are difficult to diagnose without a specific protocol or consensus to detect them due to the number of symptoms and diseases with which it has a relationship. Therefore, the aim of this review was to analyze the diagnostic tools of CD used in middle-aged women, to compare the use and effectiveness of the different tools, and to propose a strategy for the use of the tools based on the results found in the literature. The present research followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The search was conducted in the following databases: Scielo, PubMed, Web of Science, and Worldwide Science org. In the initial literature search, 2004 titles and relevant abstracts were found. Among them, 687 were duplicates, leaving 1130 articles. Based on the inclusion criteria, only 41 articles passed the selection process; 4 main types of analyses appear in the studies: blood tests, questionnaires, clinical history, and biopsy. It can be said that none of the analyses have a 100% reliability since most of them can present false negatives; therefore, the best way to diagnose celiac disease up to now is through a combination of different tests (Immunoglobulin A and small intestinal biopsy).

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Section: Discussionmentioning

confidence: 99%

“…Flow diagram of the process of study selection.In 24 of the studies found, they used intestinal biopsy as the main source of diagnosis of celiac disease, followed by blood tests of immunoglobulin A, anti-inflammatory transglutaminase, and Immunoglobulin G[4,5,9,10,13,19,22,24,27,28,[30][31][32][39][40][41]43,45,46,[49][50][51].…”

mentioning

confidence: 99%

Tools Used to Measure the Physical State of Women with Celiac Disease: A Review with a Systematic Approach

Martínez-Rodríguez

Loaiza-Martínez

Sánchez-Sánchez

et al. 2020

IJERPH

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“…[109,110,111] We recently conducted a meta-analysis and found that women with infertility had 3.5 times higher odds of having duodenal biopsy proven CeD in comparison to that in the control population (OR 3.5, 95% CI 1.3 9; p <.01). [112] In another metaanalysis, Tersigini et al have also shown that females with unexplained infertility have about 5 times increased odds of having CeD [113].…”

Section: Gynecological Manifestationsmentioning

confidence: 97%

Non-classical Celiac Disease: Often Missed

Singh¹,

Makharia²

2016

IJCD

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Celiac disease (CeD) is an immune-mediated enteropathy triggered by ingestion of gluten in genetically susceptible individuals. CeD is a global disease and estimated to affect approximately one percent of the global population. With advent of simple serological tests for the diagnosis, the number of individuals diagnosed with CeD is increasing exponentially. It was initially thought that gluten hypersensitivity in CeD is limited to small intestine only and all other features are secondary to malabsorption, but it is now recognized that the hypersensitivity to gluten is not limited to small intestine alone and may affect other organs such as skin, brain, and bones independent of intestinal involvement. CeD is now considered a multi-system disorder and their clinical presentation may be with gastrointestinal symptoms, called "classical CeD" or more often with non-gastrointestinal symptoms called "nonclassical CeD". These patients may present with short stature, anemia, liver dysfunction (asymptomatic increase in transaminases, chronic liver disease, autoimmune hepatitis), cutaneous manifestations (dermatitis herpetiformis, oral ulcers), reproductive diseases (infertility, recurrent abortions), neurological manifestations (ataxia, peripheral neuropathy), and metabolic disorders (osteopenia/osteoporosis). What determines these variable phenotypes remain unclear but likely is a result of genetic as well as environmental factors. Many of these patients with non-classical CeD are likely to report to specialists other than gastroenterologists such as hematologists, endocrinologists, rheumatologists or gynecologists. Unfortunately, the awareness about non-classical presentations of CeD amongst health care professionals remains low. There is an urgent need to increase awareness among health care professionals about varied manifestations of CeD in order to decrease the burden of undiagnosed CeD.

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“…Data on the association between celiac disease and infertility are still considered contradictory and, at present, there are no recommendations to screen for CD in female patients with infertility. A recent meta-analysis (16) showed that women with infertility and with "unexplained infertility" are 3.5 and 6 times more likely to suffer from CD than fertile women. After 13 months of a gluten-free diet, the patient conceives naturally and gives birth to a healthy baby boy.…”

Section: Ethical Evaluation Of the Case Reportmentioning

confidence: 99%

An Ethical Dilemma in the Field of Gynecology

Valera

Terranova

2016

pers.bioet

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Un dilema ético en el campo de la ginecologíaUm dilema ético no campo da ginecologia luca valera 1 corrado terranova 2 AbSTRACTThe aim of this paper is to assess a case report in the field of gynecology, starting from an ethical paradigm that relates primarily to the so-called "sources of morality" (objective structure, circumstances, aim). In order to do so, we first will present four ethical paradigms for the evaluation of clinical cases (preference utilitarianism, principlism, ontologically-grounded personalism and Aristotelian/Thomist objective ethics). After introducing the main aspects of these paradigms and pointing out that what matters in an ethical evaluation is not so much the final judgement, but rather the argument that leads to it, we will assess the case report in light of the chosen paradigm. Lastly, we will outline a possible solution to the problem, starting from the previous ethical evaluation.

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Celiac Disease in Women With Infertility

Abstract: CeD is more prevalent in women with "all-cause" infertility and "unexplained" infertility than that in general population.

Cited by 49 publications

References 39 publications

Tools Used to Measure the Physical State of Women with Celiac Disease: A Review with a Systematic Approach

Tools Used to Measure the Physical State of Women with Celiac Disease: A Review with a Systematic Approach

Non-classical Celiac Disease: Often Missed

An Ethical Dilemma in the Field of Gynecology

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