Celiac sprue and refractory sprue

Trier, Jerry S.; Falchuk, Z. Myron; Carey, Martin C.; Schreiber, David S.

doi:10.1016/0016-5085(78)90423-7

Cited by 140 publications

(66 citation statements)

References 48 publications

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“…In untreated patients, mucosa is flattened and the normal villous architecture is lost. Mitotic activity and the number of undifferentiated cells are markedly increased and the crypts get longer (1,19). Marsh first described the progression of the small intestinal lesions in 1992.…”

Section: Discussionmentioning

confidence: 98%

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Celiac Disease in the Turkish Population

et al. 2005

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Celiac disease (CD) is characterized by malabsorption of nutrients in the small intestine. The availability of highly specific and sensitive serologic tests has facilitated its diagnosis, increasing the disease prevalence. The aim of this study was to determine the clinical, laboratory, and histopathological features of CD in Turkish adults. Between 1968 and 2002, CD patients presenting to the Gastroenterology Unit were evaluated retrospectively. From 2002, newly diagnosed patients were prospectively followed up. Sixty patients (39 female, 21 male) were included in the study. Mean body mass index was 22.2 +/- 5.4 kg/m2. The most common symptoms were diarrhea, weight loss, and flatulence. Most common comorbidities were anemia, osteoporosis, type 1 diabetes mellitus, and steatohepatitis. Six (10.0%) patients had a family history of diabetes mellitus; one (1.7%) patient had a family history of CD. Plasma glucose and serum gamma-glutamyltransferase levels were significantly higher in females than males. Most common histopathological findings were increased lymphocytes in the lamina propria (76.2%) and villus epithelium (59.5%). Over the years, the cumulative frequency of CD increased more in females than males. This is the first study in the literature showing the characteristics of CD in Turkish adults. In our previous recent study, the prevalence of tissue transglutaminase antibody positivity in Turkish healthy blood donors was 1.3%, indicating a high prevalence of CD in our population. In this study, the cumulative frequency of CD increased more in females than males. With the better understanding and increased suspicion of the disease, more patients are being diagnosed in our population.

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Section: Discussionmentioning

confidence: 98%

“…The incidence in monozygotic twins increases to 70% (1,19). Celiac disease is related to a specific HLA class II DQ haplotype (1).…”

Section: Discussionmentioning

confidence: 99%

Celiac Disease in the Turkish Population

et al. 2005

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“…Refractory celiac disease (RCD) is a combination of continued or recurrent severe malabsorption, progressive malnutrition, intestinal villous atrophy on repeat biopsy, and increased mortality despite compliance with a GFD for more than 6 months [90]. This condition affects approximately 3% of CD patients.…”

Section: Refractory Celiac Diseasementioning

confidence: 99%

Gluten‐Sensitive Enteropathy

Rubio–Tapia

Murray

2013

Food Allergy

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“…Electronic Supplementary Material is available in the online version of this article at http://dx.doi.org/10.1007/s00063-008-1091-2 and is accessible for authorized users. Key Words: Celiac disease · Enteropathy-associated malignancies · T-cell, B-cell lymphoma · Refractory disease type I/type II · Chronic inflammation · Prevention strategies · Ultrasound [47][48][49][50][51][52][53]; darüber hinaus kann aber auch eine lange Krankheitsdauer per se (> 20 Jahre) trotz glutenfreier Kost mit einer Häufung von Malignomen einhergehen, wie eine kürzlich publizierte epidemiologische Studie zeigt, in der auch unter glutenfreier Kost noch eine stark erhöhte SMR für Non-Hodgkin-Lymphome von 6,2 (2,9-14,0) beobachtet wurde [29]. Eine therapierefraktäre Sprue wird allgemein angenommen, wenn die klinischen Beschwerden und Funktionseinschrän-kungen sowie die endoskopisch-histologischen und immunologischen Entzündungszeichen trotz glutenfreier Kost über längere Zeit (> 3-6 Monate) weiter bestehen und/oder wieder auftreten [47][48][49][50][51][52][53].…”

Section: Prävalenz Und Inzidenz Maligner Erkrankungen Bei Einheimischunclassified

“…Key Words: Celiac disease · Enteropathy-associated malignancies · T-cell, B-cell lymphoma · Refractory disease type I/type II · Chronic inflammation · Prevention strategies · Ultrasound [47][48][49][50][51][52][53]; darüber hinaus kann aber auch eine lange Krankheitsdauer per se (> 20 Jahre) trotz glutenfreier Kost mit einer Häufung von Malignomen einhergehen, wie eine kürzlich publizierte epidemiologische Studie zeigt, in der auch unter glutenfreier Kost noch eine stark erhöhte SMR für Non-Hodgkin-Lymphome von 6,2 (2,9-14,0) beobachtet wurde [29]. Eine therapierefraktäre Sprue wird allgemein angenommen, wenn die klinischen Beschwerden und Funktionseinschrän-kungen sowie die endoskopisch-histologischen und immunologischen Entzündungszeichen trotz glutenfreier Kost über längere Zeit (> 3-6 Monate) weiter bestehen und/oder wieder auftreten [47][48][49][50][51][52][53]. Obwohl die Pathogenese der malignen Entartung nicht im Einzelnen geklärt ist, scheinen nach heutiger Ansicht die persistierende chronische Entzündung mit Aktivierung oligo-/monoklonaler T-Zellen und die Produktion proinflammatorischer/proliferationsfördernder Zytokine in der Dünndarmschleimhaut eine wichtige Rolle zu spielen [54][55][56][57][58][59][60][61][62][63].…”

Section: Prävalenz Und Inzidenz Maligner Erkrankungen Bei Einheimischunclassified

Einheimische Sprue und Malignomrisiko

Allgayer

Dietrich

2008

Med Klin

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Although the absolute risk of enteropathy-associated malignancies in celiac disease is generally very small due to low prevalence/incidence rates, the relative risk may be considerable so that prevention strategies based on appropriate data seem clinically desirable. The great majority of the case-control and cohort studies which have been published in the last years point to a significantly elevated risk for tumors in the gastrointestinal (GI) tract in terms of hazard/odds ratios, observed/expected ratios, and/or standardized incidence/morbidity ratios in the magnitude>5.0, whereas the risk for tumor outside the GI tract seems to be much lower (PubMed December 2007). Chronic inflammation with persistent symptoms/complaints and especially chronic refractory disease type II are considered to be particular individual risk factors. In addition, genetic factors and/or certain gene combinations may unfavorably influence the course of the disease. In the absence of controlled and prospective trials and corresponding evidence-based guidelines as they have been published for colon cancer, the strategies of prevention in patients with celiac disease differ from center to center according to their own experience/ expertise. Besides regular clinical, serologic/immunologic and endoscopic/histologic assessment a careful history taking with special regard to the disease course and a detailed ultrasound examination of the entire abdomen in patients at risk may play an important role in the long-term follow-up.

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Celiac sprue and refractory sprue

Cited by 140 publications

References 48 publications

Celiac Disease in the Turkish Population

Celiac Disease in the Turkish Population

Gluten‐Sensitive Enteropathy

Einheimische Sprue und Malignomrisiko

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