Patchy Villous Atrophy of the Duodenum in Childhood Celiac Disease

Bonamico, Margherita; Mariani, P; Thanasi, Enina; Ferri, M.; Nenna, Raffaella; Tiberti, Claudio; Mora, Barbara; Mazzilli, Maria Cristina; Magliocca, Fabio Massimo

doi:10.1097/00005176-200402000-00019

Cited by 178 publications

(141 citation statements)

References 18 publications

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“…[28][29][30][31] In patients that have already initiated GFD, even before the confirmation biopsy, with high CD suspicion and negative serology, a test with a diet containing gluten may be performed, in this case for at least four weeks and, afterwards, biopsy. However, some patients are late responders and may take years to have their histology altered.…”

Section: Duodenal Biopsymentioning

confidence: 99%

Diagnóstico de doença celíaca em adultos

Silva

Furlanetto

2010

Rev. Assoc. Med. Bras.

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Celiac disease (CD) is found in genetically predisposed individuals, and characterized by intolerance to gluten ingestion, contained in cereals such as barley, rye, wheat and malt. Clinical manifestations vary from asymptomatic patients to severe forms of malabsorption syndromes, which may involve multiple systems and increase the risk of some neoplasias. Diagnosis of CD often requires a high degree of suspicion. There is not a single test for the diagnosis, which is reached after a combination of clinical and laboratory data. The first step may be a serum test, such as the antibodies anti-tissue transglutaminase, or antiendomisio. If serum result is positive, duodenal biopsy is necessary for diagnostic confirmation. IgA deficiency, which occurs in 3% of patients with DC, may lead to false-negatives because serology is based on IgA antibodies. Another cause of false-negative tests is diet restriction of gluten; therefore diagnostic investigation must be carried out during a diet containing gluten. The screening for CD in asymptomatic individuals is not indicated.

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Section: Duodenal Biopsymentioning

confidence: 99%

Diagnóstico de doença celíaca em adultos

Silva

Furlanetto

2010

Rev. Assoc. Med. Bras.

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“…There is evidence to support both sides of this argument, derived from studies conducted in North America, England, Australia and South America, including increased deleterious haemoglobin content, increased incidence of jaundice and polycythemia in infants delivered using late clamping. [2][3][4][5] However, early clamping has been thought to possibly deprive the newborn of potentially needed red cells and iron. [2][3][4][5] Regardless, in the USA it has been common practice for more than 50 years to deliver infants utilising what would be termed early clamping.…”

Section: In Responsementioning

confidence: 99%

“…Besides xanthaelasma and xanthoma, presence of arcus juvenilis in young people (age р40 years) may also be considered as a clinical sign for premature CAD. 3 Premature graying and/or balding in chronic smokers has also been shown to be associated with premature CAD. 4 Other cutaneous signs like ear lobe crease, ear canal hair, and nicotine staining should be considered as valuable clinical markers of CAD for the benefit of the readers.…”

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confidence: 99%

Using umbilical cord blood stem cells for myocardial infarction and stroke is ethically challenging

Bewley

Mercer

2010

Clinical Medicine

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“…An expert pathologist will interpret the most severely affected biopsy to either confirm or exclude the diagnosis of celiac disease. Although highly reliable, the diagnostic yield of an intestinal biopsy is not perfect, in part due to a patchy enteropathy in less severe cases (3,29). In rare cases with normal biopsy and positive tTG or EMA serology, serious consideration should be given to repeating the biopsy at a later date.…”

Section: Intestinal Biopsy: the Final Word On Diagnosismentioning

confidence: 99%

Practical considerations for the identification and follow-up of children with celiac disease

Dirks

2004

Paediatrics &Amp; Child Health

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Celiac disease is an immune-mediated enteropathy affecting 0.5% to 1% of children and is induced by dietary gluten in susceptible individuals carrying the human leukocyte antigen DQ2 or DQ8 heterodimer. If serological screening is positive or if a patient displays suggestive symptoms, an endoscopic biopsy of the distal duodenum is required to confirm the diagnosis. Symptoms of celiac disease are often mild or absent. Overt malabsorption occurs in only 2% to 10% of children. Individuals with a higher risk of developing celiac disease, including first-degree relatives of affected patients and children with type I diabetes, Turner syndrome, Williams syndrome or Down syndrome, should be offered screening for celiac disease along with a discussion of the implications. If serological testing is negative, a high index of suspicion should remain if malabsorption, iron deficiency or osteopenia is present. Also, immunoglobulin A deficiency should be excluded. At-risk individuals should undergo serial serological screening. Lifelong adherence to a gluten-free diet is the only treatment. If left untreated, symptomatic children with celiac disease carry an increased risk of developing osteoporosis and have a greater lifetime risk of cancer. The long-term outcome of undiagnosed or untreated asymptomatic individuals is less clear.Key Words: Celiac disease; Gluten-free diet; Gluten-sensitive enteropathy; IgA deficiency; Tissue transglutaminase; Type I diabetes Des considérations pratiques pour dépister et suivre les enfants atteints d'une maladie coeliaqueLa maladie coeliaque est une entéropathie d'origine immunologique qui touche de 0,5 % à 1,0 % des enfants et qui est induite par le gluten diététique chez des individus susceptibles porteurs de l'antigène HLA DQ2 ou DQ8 hétérodimère. Si le dépistage sérologique est positif ou si un patient présente des symptômes évocateurs, une biopsie endoscopique du duodénum distal s'impose pour confirmer le diagnostic. Les symptômes de maladie coeliaque sont souvent légers ou inexistants. Une malabsorption patente ne s'observe que chez 2 % à 10 % des enfants. Les individus plus vulnérables à la maladie coeliaque, y compris les parents au premier degré des patients atteints et les enfants souffrant

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Patchy Villous Atrophy of the Duodenum in Childhood Celiac Disease

Cited by 178 publications

References 18 publications

Diagnóstico de doença celíaca em adultos

Diagnóstico de doença celíaca em adultos

Using umbilical cord blood stem cells for myocardial infarction and stroke is ethically challenging

Practical considerations for the identification and follow-up of children with celiac disease

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