Obesity in Celiac Sprue

Atypical presentation of coeliac disease

“…Coeliac disease is characterised histologically by total or subtotal villous atrophy. These changes tend to be greatest in the proximal small bowel 3 4. Our patients were probably able to compensate for proximal malabsorption by using intact absorptive mechanisms more distally.…”

“…This obesity had developed despite the persistence of villous atrophy on jejunal biopsy. It is postulated that as the surface area of the small bowel increases with age, children develop the ability to ingest adequate compensatory energy 4. Children whose energy intake is excessive will become obese.…”

“…It is not certain why only a few patients are overweight, but it probably reflects an underlying tendency to obesity in some individuals 4. We recommend that all patients with suggestive symptoms, nutrient deficiencies, or positive family history have serological testing for coeliac disease irrespective of their body weight.…”

Vitamin D Status and Adiposity in Pediatric Malabsorption Syndromes

“…The lack of a significantly reduced 25(OH)D concentration in patients with malabsorption syndrome compared to controls may be partly explained by the absence of the diminutive effect of adiposity on vitamin D in malabsorption syndrome, which in turn, results in increased bioavailability of vitamin D. Given that oral intake is not the primary source of vitamin D in humans, it is likely that patients with malabsorption syndromes synthesize adequate amounts of vitamin D following exposure to ultraviolet radiation. The phenomenon of mucosal absorptive compensation which results in increased vitamin D absorptive capacity by unaffected mucosal surfaces [23] may also explain the parity in serum 25(OH)D between the controls and subjects with malabsorption syndrome. This phenomenon which has been described in CD may also occur in LI and IBD.…”

Severe Malnutrition and Celiac Disease Following Gastric by-Pass Surgery

“…Cuenca-Abente and col. (2012) report five patients being diagnosed with CD based on endoscopic findings during pre-surgical evaluation for bariatric surgery [9] and bibliographic investigation offered three cases where the diagnosis of CD was performed after a jejunoileal by-pass [10,11,12], one of them with fatal outcome due to hepatorenal failure.…”