Hyposplenism and gluten-sensitive enteropathy

O’Grady, John; Stevens, Fiona; Harding, B.; O'Gorman, T; McNicholl, B; McCarthy, Colm

doi:10.1016/0016-5085(84)90199-9

Cited by 44 publications

(8 citation statements)

References 28 publications

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“…The present report describes a patient with recurrent episodes of watery diarrhea, initially attributed to lymphocytic colitis, a condition previously seen in celiac disease (20). In addition, weight loss and hypoproteinemia developed, and hyposplenism was later detected, which has also been described in celiac disease (21) as well as in small bowel lymphoma complicating celiac disease (22). Finally, antiendomysial antibodies, serological markers of adult celiac disease (23), were also detected.…”

supporting

confidence: 55%

Hyposplenism, Antiendomysial Antibodies and Lymphocytic Colitis in Collagenous Sprue

Freeman

1999

Canadian Journal of Gastroenterology and Hepatology

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A 66-year-old woman was seen repeatedly over a decade to remove recurrent colonic adenomas and investigate episodes of watery diarrhea. Although the diarrhea was believed to be due to lymphocytic colitis, she developed weight loss, hypoproteinemia and hyposplenism that resulted in further studies, specifically to exclude celiac disease. Small intestinal biopsies, however, showed severely 'flattened' villous architecture with trichrome-positive subepithelial collagenous deposits, characteristic of collagenous sprue. Antiendomysial antibodies, known serological markers of celiac disease, were also detected. While collagenous sprue has been considered a distinct small intestinal disorder, the constellation of clinical and pathological findings in this patient suggests a close link with adult celiac disease.

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supporting

confidence: 55%

Hyposplenism, Antiendomysial Antibodies and Lymphocytic Colitis in Collagenous Sprue

Freeman

1999

Canadian Journal of Gastroenterology and Hepatology

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“…In a previous report on elderly celiac patients (4), for example, a review of peripheral blood films led to the recognition of hyposplenism in 13%. In contrast, studies using the clearance of isotopically labelled red blood cells or pitted red blood cell counts have shown that up to 75% of patients with celiac disease may have hyposplenism (5,34). Therefore, it can be predicted that the frequency of hyposplenism in different colonic inflammatory bowel disorders, such as collagenous colitis, is much greater than is appreciated.…”

Section: Discussionmentioning

confidence: 97%

“…I mpaired splenic function has frequently been recognized in several clinical disorders (1), including diseases causing malabsorption, such as celiac disease (2)(3)(4)(5), as well as tropical sprue (6), Whipple's disease (7) and intestinal lymphangiectasia (8). Hyposplenism has been associated with other chronic diarrheal disorders, usually involving the large intestine, including both ulcerative colitis and Crohn's disease (9)(10)(11).…”

mentioning

confidence: 99%

Functional Asplenia and Microscopic (Collagenous) Colitis

Freeman

1996

Canadian Journal of Gastroenterology

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A 54-year-old female presented with a pulmonary infection that resolved completely with antibiotic treatment. Peripheral blood films showed features characteristic of splenic hypofunction, and radiolabelling studies confirmed an absence of splenic reticulo-endothelial cell activity, which is typical of functional asplenia. The patient had a remote history of watery diarrhea but no clinical and laboratory features of malabsorption. Extensive upper and lower gastrointestinal tract biopsy studies revealed histopathological features of collagenous colitis without gastric or small intestinal inflammatory changes or epithelial lymphocytosis. Hyposplenism has been associated with different gastrointestinal disorders, particularly celiac disease. This is the first report of functional asplenia and microscopic collagenous colitis.

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“…45 Hyposplenism may be reversible with the gluten free diet (GFD), but that remains controversial. 46,47 Celiac disease is frequently associated with several autoimmune disorders, including Hashimoto's thyroiditis, insulin-dependent diabetes mellitus, Sjogren's syndrome, Addison disease, systemic lupus erythematosus, rheumatoid arthritis. 48,49 The evidence that autoantibodies may develop within months of splenectomy together with the demonstration that celiac patients with blood film features of hyposplenism have a higher prevalence of autoantibodies have led to the hypothesis that defective splenic function might predispose the development of autoimmunity in celiac disease.…”

Section: Hyposplenismmentioning

confidence: 99%

“…Splenic atrophy or splenic hypofunction is an important although not essential component of CMLNS. 46,55,56 Tinguria and Liaconis reported a case of refractory celiac disease in a patient who presented with intestinal obstruction secondary to ulcerative jejunitis and cavitating mesenteric lymph node syndrome. 57 Imaging studies are useful in suspecting the diagnosis of CMLNS in patients with celiac disease and confirmation is achieved by pathological evaluation of the excised mesenteric lymph nodes.…”

Section: Cavitating Mesenteric Lymph Node Syndromementioning

confidence: 99%

Rare Complications of Celiac Disease: Clinicopathologic Features

Tinguria¹

2023

MRAJ

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Celiac disease (CD) is an immune mediated disorder characterised by intolerance to glutens in certain grains like whet, barley, and rye. The exposure to gliadin protein component in the susceptible individuals leads to an inflammatory reaction damaging small bowel mucosa with progressive disappearance of intestinal villi. The damaged intestinal mucosa leads to malabsorption. The usual symptoms of celiac disease include diarrhea, steatorrhea, weight loss, fatigue, and abdominal pain. Diagnosis is based on clinical features, duodenal biopsy, elevated levels of anti-gliadin antibodies and response to gluten free diet. Contrary to common belief, celiac disease is a protein systemic disease rather than merely a pure digestive alteration. Celiac disease is closely associated with genes that code HLA -II antigens mainly of DQ2 and DQ8 classes, production of disease specific antibodies (i.e., endomysial antibodies), multiorgan involvement, comorbidity with other autoimmune diseases (shared autoimmunity), familial aggregation, and immune system dysregulation. The clinical presentation of celiac disease can be variable. In mild form, patients can be almost asymptomatic whereas in the most severe form, the patients are at increased risk of life-threatening complications. Celiac disease has a well-known association with other autoimmune diseases such as autoimmune liver diseases (autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis), diabetes mellitus, autoimmune thyroid diseases, skin diseases such as dermatitis herpetiformis, rheumatoid arthritis, systemic lupus erythematosus, Sjogren’s syndrome, psoriasis, sarcoidosis, immune thrombocytopenic purpura, and pancreatitis. In addition, celiac disease may be associated with rare but potentially serious complications such as, collagenous sprue, ulcerative jejunoileitis, refractory celiac disease (RCD), enteropathy associated T-cell lymphoma, small bowel adenocarcinoma (SBA), hyposplenism, and cavitating mesenteric lymph node syndrome (CMLNS). The present article describes clinicopathologic features of these rare but serious complications of celiac disease.

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Hyposplenism and gluten-sensitive enteropathy

Cited by 44 publications

References 28 publications

Hyposplenism, Antiendomysial Antibodies and Lymphocytic Colitis in Collagenous Sprue

Hyposplenism, Antiendomysial Antibodies and Lymphocytic Colitis in Collagenous Sprue

Functional Asplenia and Microscopic (Collagenous) Colitis

Rare Complications of Celiac Disease: Clinicopathologic Features

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