Celiac disease: A missed cause of metabolic bone disease

Rastogi, Ashu; Bhadada, Sanjay Kumar; Bhansali, Anil; Kochhar, Rakesh; Ramakrishnan, Santosh

doi:10.4103/2230-8210.100674

Cited by 20 publications

(7 citation statements)

References 29 publications

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“…Patients with celiac disease experience metabolic bone diseases, including osteoporosis, osteopenia, and bone fractures (10,(17)(18)(19)(20)(21). There are several factors that affect the development of metabolic bone disease in patients with celiac disease.…”

Section: Discussionmentioning

confidence: 99%

Vitamin and mineral deficiency in children newly diagnosed with celiac disease

Topal¹,

Çatal²,

Acar³

et al. 2015

Turk J Med Sci

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IntroductionCeliac disease is a chronic autoimmune disease that particularly affects the proximal small bowel (1). An autoimmune-mediated mechanism plays a part in the pathophysiology of the disease, and small bowel mucosal injury and malabsorption occur due to the hypersensitivity to gluten in prone individuals. Vitamin and mineral deficiency may also be seen depending upon malabsorption. Consequently, the clinical symptoms of the disease are not limited to the gastrointestinal system and may appear with a heterogeneous clinical spectrum involving the extraintestinal system. The typical symptoms of the disease include chronic diarrhea, abdominal distention, and growth retardation (2,3). However, the disease may also manifest itself with extraintestinal findings related to the hematologic, endocrine, and autoimmune systems. Anemia is the most frequently seen disorder in the hematologic system that often develops due to iron deficiency (4-9). Hypocalcemia and osteopenia may also occur due to vitamin D deficiency (10,11). No extensive study has been conducted regarding the vitamin and mineral deficiencies of pediatric patients diagnosed with celiac disease up to the present. Accordingly, it is the objective of this study to determine the frequency of vitamin A, D, and E deficiency, as well as zinc and mineral deficiencies, in pediatric patients diagnosed with celiac disease at the time of application to our clinic. Materials and methodsThe files of the patients diagnosed with celiac disease and followed in our Pediatric Gastroenterology, Hepatology, and Nutrition Clinic from June 2008 to June 2013 were reviewed retrospectively. Patients with complete file records and vitamin and mineral levels checked at the time of application were enrolled in the study. The demographic characteristics, complaints at the time of application, findings of duodenal biopsy, and serum 25 OH vitamin D, vitamin A, vitamin E, iron, and zinc levels of the patients were taken from the file records. The study was approved by the Ethics Committee of İnönü University (approval number 162/2013).The diagnosis of celiac disease was established in accordance with the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition's guidelines Background/aim: To establish the frequency of vitamin and mineral deficiency in children newly diagnosed with celiac disease. Materials and methods:The files of patients diagnosed with celiac disease in our Pediatric Gastroenterology Clinic from June 2008 to June 2013 were reviewed retrospectively.Results: A total of 52 pediatric patients diagnosed with celiac disease via serology and duodenal biopsy and who fulfilled the study criteria were enrolled in the study. The mean diagnosis age of the patients was 8.5 ± 3.9 years and 33 (63.5%) of the patients were female. Vitamin D, vitamin A, vitamin E, zinc, and iron deficiencies were determined in 27 (51.9%), 4 (7.7%), 7 (13.5%), 35 (67.3%), and 18 (34.6%) patients, respectively, at the time of diagnosis. Vitamin D deficiency was observed more frequent...

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Section: Discussionmentioning

confidence: 99%

Vitamin and mineral deficiency in children newly diagnosed with celiac disease

Topal¹,

Çatal²,

Acar³

et al. 2015

Turk J Med Sci

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“…Most of the subsequent reports on CD came from the northern part of India (States of Punjab, Haryana, Delhi, Rajasthan, Uttar Pradesh), where wheat is the staple dietary cereal [6,7,8,9,10,11,12,13,14,25,26,27,28]. …”

Section: Celiac Disease In Asiamentioning

confidence: 99%

“…Although there has been an increase in the number of publications on CD from the Asian region, there is a paucity of literature on its prevalence in most Asian nations, with the exception of India [6,7,8,9,10,11,12,13,14]. Additionally, few case reports and short reports are available from China, Pakistan and Japan [15,16,17,18,19,20].…”

Section: Introductionmentioning

confidence: 99%

Celiac Disease Screening in Southern and East Asia

Makharia

2015

Dig Dis

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Until 1970s, celiac disease (CD) was considered to be an uncommon disease except in Western Europe. The global epidemiology of CD continues to evolve with improvement in the diagnostic tests, simplification of the diagnostic criteria and increase in awareness about the disease. The Asian region is currently at the crossroads of the frontier of knowledge and awareness of CD. In many Asian nations, CD is still considered to be either nonexistent or very rare. A notable exception is India, where CD has been well recognized, especially in the northern part, and 2 population-based studies have revealed a prevalence of 0.3-1.04%. Initial reports from Malaysia, China, Japan and Singapore suggest the existence of CD in these countries. Furthermore, a meta-analysis of the predisposing factors predicts a high probability of occurrence of CD in fair numbers in China. There are no formal reports on CD from Malaysia, Indonesia, Korea, Taiwan and many other nations in this region. With the impending CD epidemic in Asia, there are many challenges. Some of the efforts which are required include determination of prevalence of CD across the region, spreading of awareness among physicians and patients, training of dieticians for proper counseling and supervision of patients, creation of gluten-free food infrastructure in the food supply and creation of patient advocacy organizations. Although the absolute number of patients with CD at present is not very large, this number is expected to increase over the next few years/decades. It is thus appropriate that the medical community across Asia define the extent of the problem and get prepared to handle the impending CD epidemic.

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“…Earlier, we have reported that CD co-occurs with a number of diseases [ 5 – 8 ], whereas some other studies reported that microbes/infections modulate the disease presentations in CD [ 9 – 13 ]. By sequencing the genomes of microbes, we attempted to identify the genetic basis of pathogenicity, particularly microbial virulence and its probable role in CD [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Genome sequence and comparative genomic analysis of a clinically important strain CD11-4 of Janibacter melonis isolated from celiac disease patient

et al. 2018

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BackgroundJanibacter melonis and other member of this genus are known to cause bacteremia and serious clinical comorbidities, but there is no study reporting about pathogenicity attributes of J. melonis. Janibacter terrae is known to cause lethal infection. Reporting the genome of J. melonis CD11-4 and comparative genomics with other members of genus has provided some novel insights that can enable us to understand the mechanisms responsible for its pathogenicity in humans.ResultsComparative genomic analysis by Rapid Annotation Server and Technology revealed the presence of similar virulence determinant genes in both J. terrae NBRC 107853T and J. melonis CD11-4. Like J. terrae NBRC 107853T, J. melonis CD11-4 contained two genes responsible for resistance against β-lactam class of antibiotics and two genes for resistance against fluoroquinolones. Interestingly, J. melonis CD11-4 contained a unique gene coding for multidrug resistance efflux pumps unlike all other members of this genus. It also contained two genes involved in Toxin-antitoxin Systems that were absent in J. terrae NBRC 107853T but were present in some other members of genus.ConclusionsGenome annotations of J. melonis CD11-4 revealed that it contained similar or more virulence repertoire like J. terrae NBRC 107853T. Like other gut pathogens, J. melonis possesses key virulence determinant genes for antibiotic resistance, invasion, adhesion, biofilm formation, iron acquisition and to cope with stress response, thereby indicating that strain J. melonis CD11-4 could be a gut pathogen.

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Celiac disease: A missed cause of metabolic bone disease

Cited by 20 publications

References 29 publications

Vitamin and mineral deficiency in children newly diagnosed with celiac disease

Vitamin and mineral deficiency in children newly diagnosed with celiac disease

Celiac Disease Screening in Southern and East Asia

Genome sequence and comparative genomic analysis of a clinically important strain CD11-4 of Janibacter melonis isolated from celiac disease patient

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