Male gonadal function in coeliac disease: 1. Sexual dysfunction, infertility, and semen quality

Farthing, M J G; Edwards, C. R. W.; Rees, Leslie; Dawson, A. M.

doi:10.1136/gut.23.7.608

Cited by 77 publications

(59 citation statements)

References 24 publications

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“…48 In males, impotence, decreased sexual activity, infertility, abnormalities of sperm morphology and motility may be expressions of CD. 49,50 Another presentation of atypical CD is so-called celiac hepatitis, characterized by a gluten-dependent increase in serum transaminases without abnormality of any other liver functions. 51 Both the serum transaminases and mild liver histological damage revert to normal after removal of gluten.…”

Section: Introductionmentioning

confidence: 99%

Celiac disease: diagnostic criteria in progress

2011

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Until a few years ago, celiac disease (CD) was thought to be a rare food intolerance that was confined to childhood and characterized by severe malabsorption and flat intestinal mucosa. Currently, CD is regarded as an autoimmune disorder that is common in the general population (affecting 1 in 100 individuals), with possible onset at any age and with many possible presentations. The identification of CD is challenging because it can begin not only with diarrhea and weight loss but also with atypical gastrointestinal (constipation and recurrent abdominal pain) and extra-intestinal symptoms (anemia, raised transaminases, osteoporosis, recurrent miscarriages, aphthous stomatitis and associated autoimmune disorders), or it could be completely symptomless. Over the last 20 years, the diagnostic accuracy of serology for CD has progressively increased with the development of highly reliable tests, such as the detection of IgA tissue transglutaminase and antiendomysial and IgG antideamidated gliadin peptide antibodies. The routine use of antibody markers has allowed researchers to discover a very high number of 'borderline' cases, characterized by positive serology and mild intestinal lesions or normal small intestine architecture, which can be classified as potential CD. Therefore, it is evident that the 'old celiac disease' with flat mucosa is only a part of the spectrum of CD. It is possible that serology could identify CD in its early stages, before the appearance of severe intestinal damage. In cases with a positive serology but with mild or absent intestinal lesions, the detection of HLA-DQ2 and HLA-DQ8 can help reinforce or exclude the diagnosis of gluten sensitivity.

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Section: Introductionmentioning

confidence: 99%

Celiac disease: diagnostic criteria in progress

2011

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“…Sexual dysfunction is common without other features of hypogonadism, and improves after gluten withdrawal. Abnormalities of sperm morphology and motility are common in both untreated and treated patients (Farthing et al, 1982). Androgen resistance (Farthing et al, 1983b) and associated hypothalamo-pituitary dysfunction were confirmed after studying 39 men with coeliac disease compared with 19 nutritionally matched but younger males with Crohn's disease.…”

Section: Gastrointestinal Diseasementioning

confidence: 90%

Gonadal function in men with chronic illness

Turner

Wass

1997

Clinical Endocrinology

103

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“…Of these, 395 were excluded, and eighteen potentially relevant studies were evaluated. Six studies were excluded because they did not fulfilled elegibility criteria: three studies lacked a control group (5,13,17) , a large population-based study (9) was not designed to compare infertility prevalence in celiac subjects and used U.S. general population as a control group; another study (20) used an inadequate control group (previously known prevalence of silent CD in the northen Sardinian population) and another one (7) assessed the risk of infertility only in male subjects and used Crohn's disease patients as control group. Finally, as shown in Figure 1, twelve studies were included for analysis.…”

Section: Resultsmentioning

confidence: 99%

“…However, these studies do not mention a relationship between CD and certain factors related to male infertility, such as hypogonadism or semen quality deficiencies. Farthing et al (7) described a high frequency of seminal alterations and sexual dysfunction in a cohort of CD male patients compared to Crohn's disease subjects.…”

mentioning

confidence: 99%

RISK OF INFERTILITY IN PATIENTS WITH CELIAC DISEASE: a meta-analysis of observational studies

Lasa¹,

Zubiaurre²,

Soifer³

2014

Arq. Gastroenterol.

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ContextCeliac disease is an autoimmune disorder of the small intestine associated with several extra-intestinal features, such as reproductive disorders. The relationship between celiac disease and infertility has been previously assessed, with conflicting results.ObjectivesWe seek to determine the relationship between celiac disease and infertility.MethodsData was extracted from case-control or cohort design studies from 1966 to December 2013 using the MEDLINE-Pubmed, EMBASE, LILACS and Cochrane Library databases. We analyzed two kinds of trials: those assessing the risk of infertility in subjects with already diagnosed celiac disease, and those evaluating the prevalence of undiagnosed celiac disease in subjects with a diagnosis of infertility.ResultsThe search yielded 413 potentially relevant studies for revision, 12 of which were finally included for analysis. A significant association was found between women with a diagnosis of infertility and undiagnosed celiac disease [OR 3.09 (95% CI 1.74-5.49)]. When considering those studies assessing the occurrence of infertility in subjects with already-diagnosed celiac disease, no difference was found between celiac disease patients and control subjects [OR 0.99 (0.86-1.13)].ConclusionsUndiagnosed celiac disease is a risk factor for infertility. Women seeking medical advice for this particular condition should be screened for celiac disease. Adoption of a gluten-free diet could have a positive impact on fertility in this group of patients.

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Male gonadal function in coeliac disease: 1. Sexual dysfunction, infertility, and semen quality

Abstract: 1 in these patients. The aim of the present study was to determine the prevalence of infertility, sexual dysfunction, and

Cited by 77 publications

References 24 publications

Celiac disease: diagnostic criteria in progress

Celiac disease: diagnostic criteria in progress

Gonadal function in men with chronic illness

RISK OF INFERTILITY IN PATIENTS WITH CELIAC DISEASE: a meta-analysis of observational studies

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