Refractory celiac disease

Rishi, Abdul; Rubio–Tapia, Alberto; Murray, Joseph A.

doi:10.1586/17474124.2016.1124759

Cited by 30 publications

(21 citation statements)

References 67 publications

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“…For these reasons, some authors recommend to detect and treat SIBO in patients with CD who do not improve their clinical status after GFD . Despite the main reasons of unresponsiveness to diet in CD are known to be represented by gluten contamination or refractory CD, SIBO could be considered in this condition. Indeed, our analysis did not find a statistically significant correlation between SIBO and symptom persistence in CD; however, the P value of .06 suggests that a tendency toward this condition could exist even if further studies are needed, to clarify this point.…”

Section: Discussionmentioning

confidence: 99%

Small intestinal bacterial overgrowth and celiac disease: A systematic review with pooled‐data analysis

Losurdo

Marra

Shahini

et al. 2017

Neurogastroenterology Motil

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Section: Discussionmentioning

confidence: 99%

Small intestinal bacterial overgrowth and celiac disease: A systematic review with pooled‐data analysis

Losurdo

Marra

Shahini

et al. 2017

Neurogastroenterology Motil

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“…RCD is considered a rarity in pediatric age and, although its exact prevalence and incidence in adulthood is unknown, it is an uncommon condition [85]. Due to the poor response of the disease to treatment at this stage and its prognosis, it is important to correctly make the diagnosis [86], which is considered exclusion. The complete histological evaluation of the entire small intestine is needed for the diagnosis of refractoriness or complications [87].…”

Section: Refractory Anemia To the Gluten-free Dietmentioning

confidence: 99%

Multifactorial Etiology of Anemia in Celiac Disease and Effect of Gluten-Free Diet: A Comprehensive Review

et al. 2019

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Celiac disease (CD) is a multisystemic disorder with different clinical expressions, from malabsorption with diarrhea, anemia, and nutritional compromise to extraintestinal manifestations. Anemia might be the only clinical expression of the disease, and iron deficiency anemia is considered one of the most frequent extraintestinal clinical manifestations of CD. Therefore, CD should be suspected in the presence of anemia without a known etiology. Assessment of tissue anti-transglutaminase and anti-endomysial antibodies are indicated in these cases and, if positive, digestive endoscopy and intestinal biopsy should be performed. Anemia in CD has a multifactorial pathogenesis and, although it is frequently a consequence of iron deficiency, it can be caused by deficiencies of folate or vitamin B 12 , or by blood loss or by its association with inflammatory bowel disease (IBD) or other associated diseases. The association between CD and IBD should be considered during anemia treatment in patients with IBD, because the similarity of symptoms could delay the diagnosis. Vitamin B 12 deficiency is common in CD and may be responsible for anemia and peripheral myeloneuropathy. Folate deficiency is a well-known cause of anemia in adults, but there is little information in children with CD; it is still unknown if anemia is a symptom of the most typical CD in adult patients either by predisposition due to the fact of age or because biochemical and clinical manifestations take longer to appear.

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“…Two subtypes have been described: type 1 and 2, according to the different immunohistochemical phenotype. Type 1 in particular may be a complication of refractory celiac disease and is characterized by CD30 expression and singular chromosomal anomalies, such as 9q31.3 duplication or 16q12.1 deletion [118,119]. …”

Section: Origin Of Mementioning

confidence: 99%

Lymphocytic duodenitis or microscopic enteritis and gluten-related conditions: what needs to be explored?

Ierardi¹,

Losurdo²,

Iannone³

et al. 2017

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Microscopic enteritis (ME) is characterized by abnormal infiltration of intraepithelial lymphocytes in intestinal mucosa. It was described as duodenal lymphocytosis or lymphocytic duodenitis until the dedicated Consensus Conference of 2015. ME represents a common feature of several gluten-mediated and non-gluten related diseases; therefore, it is an umbrella term embracing several conditions. The most frequent causes of ME are gluten-related disorders (celiac disease, non-celiac gluten sensitivity, wheat allergy), Helicobacter pylori infection and drug-related damages. Less frequently, ME may be secondary to inflammatory bowel disease, some autoimmune conditions, immunoglobulin deficiencies, blood malignancies, infections and irritable bowel syndrome. Therefore, the differential diagnosis of ME may be challenging. The diagnosis of ME needs to be driven by predominant symptoms and patient history. However, it is often difficult to achieve an immediate identification of the underlying condition, and a broad variety of diagnostic tests may be required. Ultimately, long-term surveillance is needed for a final diagnosis in many cases, since a hidden or quiescent condition may be disclosed after a period of latency. In any case, strict collaboration between the clinician and the pathologist is pivotal. The treatment of ME should be personalized, depending on the underlying disease. For gluten-related conditions (celiac disease, gluten sensitivity, wheat allergy, dermatitis herpetiformis), a gluten-free diet may be proposed. For other conditions, a targeted etiologic treatment is necessary. In conclusion, ME represents a novel entity that is attracting increasing interest. The growing epidemiologic trend confirms that it will become a common condition in clinical practice.

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Refractory celiac disease

Cited by 30 publications

References 67 publications

Small intestinal bacterial overgrowth and celiac disease: A systematic review with pooled‐data analysis

Small intestinal bacterial overgrowth and celiac disease: A systematic review with pooled‐data analysis

Multifactorial Etiology of Anemia in Celiac Disease and Effect of Gluten-Free Diet: A Comprehensive Review

Lymphocytic duodenitis or microscopic enteritis and gluten-related conditions: what needs to be explored?

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