Effects of Additional Dietary Gluten on the Small-Intestinal Mucosa of Volunteers and of Patients with Dermatitis Herpetiformis

Ferguson, Anne; Jn, Blackwell; Rs, Barnetson

doi:10.3109/00365528708991895

Cited by 44 publications

(14 citation statements)

References 13 publications

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“…Weinstein (20) first described two patients with dermatitis herpetiformis and normal jejunal biopsies in whom typical coeliac-like enteropathy developed after the addition of extra gluten to their normal diet. This observation has since been confirmed (21,22). There are also several case reports in the literature where an initial normal small bowel biopsy is followed by coeliac disease (23)(24)(25)(26).…”

Section: Latent Coeliac Diseasesupporting

confidence: 55%

Changing clinical features of coeliac disease

Visakorpi

Mäki

1994

Acta Paediatrica

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The classical clinical picture of coeliac disease includes prolonged diarrhoea with failure to thrive. During the past two decades this type of active presentation of coeliac disease has decreased in many European countries, giving the impression that coeliac disease is a disappearing disease. However, this is not true. The disease can be found in older children with a more or less silent presentation. Silent coeliac disease can be detected by active screening with serological tests. Coeliac disease can be suspected in children suffering from mild gastrointestinal symptoms, such as abdominal pain, and in those with signs of nutritional deficiencies, as well as in children of first‐degree relatives of already diagnosed coeliacs, patients with IgA‐deficiency, patients suffering from dental enamel hypoplasia or dermatitis herpetiformis, and patients with some other disease known to be associated with coeliac disease, such as diabetes mellitus. According to the fundamental criteria of coeliac disease, the intestinal mucosa is flat when the individual is eating gluten‐containing foods. However, this is not strictly true. Intolerance to gluten is obviously variable and the intestinal mucosa may be normal. This type of latent coeliac disease can be detected by analysing genetic markers, measuring antibodies in intestinal fluid or counting the density of intra‐epithelial gamma/delta T cells which are increased greatly even in the latent phase of coeliac disease. Thus the general concept of the natural history of coeliac disease is changing.

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Section: Latent Coeliac Diseasesupporting

confidence: 55%

Changing clinical features of coeliac disease

Visakorpi

Mäki

1994

Acta Paediatrica

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“…One approach to the problem has been to carry out a gluten challenge and demonstrate how much gluten has to be taken before intestinal mucosal inflammation and villous shortening ensue. However, such mainly short‐term studies have yielded somewhat divergent results, 4–7 and they have not been randomized.…”

Section: Introductionmentioning

confidence: 99%

The safe threshold for gluten contamination in gluten‐free products. Can trace amounts be accepted in the treatment of coeliac disease?

Collin

Thorell²,

Kaukinen

et al. 2004

Aliment Pharmacol Ther

174

107

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SUMMARYBackground: Gluten contamination in gluten-free products cannot totally be avoided. The safe threshold for gluten remains obscure. Aim: The purpose was to estimate a reasonable limit for residual gluten, based on current literature and measurement of gluten in gluten-free products on the market. Methods: The gluten content of 59 naturally gluten-free and 24 wheat starch-based gluten-free products were analysed by enzyme-linked immunosorbent assay. The daily intake of flours was calculated in 76 adults on gluten-free diet, and the intake compared with mucosal histology.

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“…In the absence of evidence to the formis [78]. In these patients, inflammation or even overt villous atrophy has ensued after gluten challenge [79]. contrary, we recommend approaching active case finding by screening, and we also treat silent celiac disease cases.…”

Section: Treatment Of Silent and Latent Celiac Diseasementioning

confidence: 99%

Clinical Features of Celiac Disease Today

Collin

Kaukinen

Mäki³

1999

Dig Dis

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The clinical spectrum of celiac disease has widened over the past decades. The condition is no longer a severe malabsorption syndrome. Instead, a typical celiac disease patient today has merely mild abdominal symptoms. Malabsorption can be subclinical or absent, and there is usually only moderate, if any, loss of weight. Simultaneously, the current prevalence has increased from 1:1,000 to 1:300 inhabitants, or even higher. Clinically silent celiac disease cases are being detected in increasing numbers since the introduction and widespread use of serologic screening tests. Symptoms of celiac disease can appear outside the intestine, a typical example being dermatitis herpetiformis. Gluten intolerance is no longer limited to overt villous atrophy. Inflammation without villous damage may be observed in genetically susceptible individuals. The term latent celiac disease is applied in situations where the patient has normal villous architecture while on a gluten-containing diet, but later develops small bowel villous atrophy compatible with celiac disease.

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Effects of Additional Dietary Gluten on the Small-Intestinal Mucosa of Volunteers and of Patients with Dermatitis Herpetiformis

Cited by 44 publications

References 13 publications

Changing clinical features of coeliac disease

Changing clinical features of coeliac disease

The safe threshold for gluten contamination in gluten‐free products. Can trace amounts be accepted in the treatment of coeliac disease?

Clinical Features of Celiac Disease Today

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