Extra-Intestinal Manifestation of Celiac Disease in Children

Jericho, Hilary; Guandalini, Stefano

doi:10.3390/nu10060755

Cited by 52 publications

(68 citation statements)

References 78 publications

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“…The rash disappears with a GFD. This condition is however rare in children 85 . Interobserver variation between pathologists assessing the same intestinal biopsy specimens has been investigated and showed fair to substantial agreement 3,4 .…”

Section: Effects Of Celiac Disease In Bloodmentioning

confidence: 97%

“…There are many different manifestations of CD in children, and they are not confined to the small intestine 85 . Examples include short stature, delayed puberty, osteoporosis, liver and biliary disease, headaches, behavioural changes, and psychiatric disorders.…”

Section: Effects Of Celiac Disease In Bloodmentioning

confidence: 99%

“…Examples include short stature, delayed puberty, osteoporosis, liver and biliary disease, headaches, behavioural changes, and psychiatric disorders. Additionally, dermatitis herpetiformis presents as a skin rash with deposits of immunoglobulin (Ig) A found in the skin 85 . The rash disappears with a GFD.…”

Section: Effects Of Celiac Disease In Bloodmentioning

confidence: 99%

See 2 more Smart Citations

Biomarkers of Inflammation and Intestinal Mucosa Pathology in Celiac Disease

Bragde

2019

Linköping University Medical Dissertations

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Celiac disease (CD) is a chronic small intestinal immune-mediated enteropathy triggered by gluten. The only currently available treatment is complying with a lifelong gluten-free diet, which should not be commenced before a CD diagnosis has been established by diagnostic test results (including histopathologic assessment of small intestinal biopsies and CD-specific antibody levels). This makes diagnostic swiftness and accuracy important. In cases with low CD-specific antibody levels and/or low-grade intestinal injuries the diagnosis can be difficult to establish. The main objective of this thesis was to complement and improve CD diagnostics by identifying and implementing new biomarkers, mainly based on gene expression, in small intestinal biopsies and blood. In paper I, genes were selected to reflect villous height, crypt elongation, immune response, and epithelial integrity. The results showed that a subset of those genes could discriminate active CD mucosa from mucosa without CD-related changes and grade the intestinal injury. In paper III, an unbiased investigation of gene expression in CD mucosa was performed using transcriptome analysis. Active CD and non-CD mucosa showed differential expression in a subset of genes, and some were differentially expressed in CD mucosa before histopathologic assessment could confirm intestinal alterations compatible with a CD diagnosis. Gene set analysis revealed that there are many biological processes affected in CD mucosa, including those associated with immune response, microbial infection, phagocytosis, intestinal barrier function, metabolism, and transportation. In parallel, gene expression was investigated in stabilised whole blood. Blood is a more accessible sampling material than intestinal biopsies, and stabilised blood is suitable for routine diagnostics since transcript levels are preserved at sampling. In paper II, expressions from a selection of genes were quantified in stabilised whole blood (RNA) and/or plasma (protein). Three genes with differential expression in CD were identified. Compared to the CD-specific autoantibodies against tissue transglutaminase (anti-TG2) alone, the addition of the information from the new potential markers resulted in a non-significant contribution to the diagnostic capacity of anti-TG2. An unbiased investigation using transcriptome analysis (paper IV) showed that gene level expression differences in stabilised whole blood were small between CD and non-CD. However, expression differences on a gene set level could potentially be used in CD diagnostics. CD-associated biological processes suggested UBD ubiquitin D ULN upper limit of normal ZFR zinc finger RNA binding protein Contents ix Contents Introduction .

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Section: Effects Of Celiac Disease In Bloodmentioning

confidence: 97%

Section: Effects Of Celiac Disease In Bloodmentioning

confidence: 99%

See 1 more Smart Citation

Biomarkers of Inflammation and Intestinal Mucosa Pathology in Celiac Disease

Bragde

2019

Linköping University Medical Dissertations

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“…The clinical presentation is broad and includes gastrointestinal upset, chronic fatigue, nutrient deficiencies, poor growth, and failure to thrive. Extra-intestinal manifestations are common, and while they were once considered more frequent in adults than children with CeD, recent data suggests the frequency is similar in CeD children, although the types and rates of recovery differ ( 8 ). In children, extra-intestinal manifestations include short stature, anemia, delayed puberty, dental enamel hypoplasia, reduced bone density, oral ulcers, liver and biliary disease, and dermatitis herpetiformis.…”

Section: Introductionmentioning

confidence: 99%

Celiac Disease: A Review of Current Concepts in Pathogenesis, Prevention, and Novel Therapies

2018

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Our understanding of celiac disease and how it develops has evolved significantly over the last half century. Although traditionally viewed as a pediatric illness characterized by malabsorption, it is now better seen as an immune illness with systemic manifestations affecting all ages. Population studies reveal this global disease is common and, in many countries, increasing in prevalence. These studies underscore the importance of specific HLA susceptibility genes and gluten consumption in disease development and suggest that other genetic and environmental factors could also play a role. The emerging data on viral and bacterial microbe-host interactions and their alterations in celiac disease provides a plausible mechanism linking environmental risk and disease development. Although the inflammatory lesion of celiac disease is complex, the strong HLA association highlights a central role for pathogenic T cells responding to select gluten peptides that have now been defined for the most common genetic form of celiac disease. What remains less understood is how loss of tolerance to gluten occurs. New insights into celiac disease are now providing opportunities to intervene in its development, course, diagnosis, and treatment.

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“…In addition, studies have shown that CD should be investigated in patients with autoimmune thyroid disease, dermatitis herpetiformis, type 1 diabetes and irritable bowel syndrome (6)(7)(8)(9). The most common extra-intestinal symptom in children is growth retardation and iron deficiency anemia in adults (10). Although CD is a gastrointestinal disease with small intestinal mucosal lesion, small intestinal mucosal damage develops gradually during the course of the disease and mucosal deterioration can take many years.…”

Section: Introductionmentioning

confidence: 99%

Extraintestinal Manifestations Associated with Celiac Disease

Kayar¹,

Dertli²,

Sürmeli³

et al. 2019

Eastern J Med

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Celiac disease (CD) can affect almost all organs of the body, including the nervous system, liver, skin, reproductive and musculoskeletal systems. In this study, it is aimed to determine the prevalence of extra-intestinal manifestations (EIMs) in adult celiac patients and to investigate the factors affecting the development of EIMs. The study included 230 celiac patients who were diagnosed and followed-up in our clinics between 2015-2019. The demographic and anthropometric characteristics, initial admissi on complaints, disease duration and dietary compliance of the patients were documented. All EIMs that accompanied the celiac disease were recorded, and their relationship with risk factors was analyzed. The age range of the patients was 18-72 years, and the mean age was 33.4±10.6 years. One hundred seventy two (74.8%) patients were female and disease follow-up was 4.8±3.5 years. The number of patients with accompanying EIMs was 202 (87.8%). Osteoporosis/osteopenia was found in 146(63.5%) patients, oral involvement in 116(50.4%) patients, arthritis/arthralgia in 96(41.7%) patients as the most common comorbidities. It was determined that, there was a significant relationship between EIM and body mass index. Although the EIMs development was less in patients wh o had strict diet; however, this was not statistically significant. The majority of adult celiac patients were found to be accompanied by EIMs. The diagnosis is delayed due to various clinical presentations. Lack of delay in diagnosis of celiac disease and consequently reduced gluten exposure seem to be the only factor in preventing some EIMs

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Extra-Intestinal Manifestation of Celiac Disease in Children

Abstract: The aim of this literature review is to discuss the extra-intestinal manifestations of celiac disease within the pediatric celiac population.

Cited by 52 publications

References 78 publications

Biomarkers of Inflammation and Intestinal Mucosa Pathology in Celiac Disease

Biomarkers of Inflammation and Intestinal Mucosa Pathology in Celiac Disease

Celiac Disease: A Review of Current Concepts in Pathogenesis, Prevention, and Novel Therapies

Extraintestinal Manifestations Associated with Celiac Disease

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