Restoration of Body Composition in Celiac Children after One Year of Gluten-Free Diet

Rea, Francesco; Polito, Cesare; Marotta, Antonio; Toro, Antonino Di; Iovene, A; Collini, R; Rea, L; Sessa, Gabriella

doi:10.1097/00005176-199611000-00007

Cited by 68 publications

(60 citation statements)

References 7 publications

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“…Physicians need to give attention to the early detection and treatment of celiac disease, as well as active detection and management of bone disease, secondary hyperparathy-roidism and vitamin D deficiency in celiac disease [17,18,55]. Celiac disease patients diagnosed and treated at a young age are more likely to return to normal bone density than those diagnosed and treated later in adulthood [56][57][58][59]. Given the general tendency for advancing age to increase fracture risk in both cases and controls, physicians should consider early measurement of bone mineral density in celiac patients, as well as measuring serum vitamin D levels with therapy including supplementation with calcium or vitamin D, as appropriate.…”

Section: Discussionmentioning

confidence: 99%

Long-term Fracture Risk in Patients with Celiac Disease: A Population-Based Study in Olmsted County, Minnesota

et al. 2007

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Celiac disease is associated with decreased bone density, but there are conflicting data regarding fracture risk. We determined the fracture incidence relative to matched controls in a population-based cohort with celiac disease before and after diagnosis. Olmsted County residents with celiac disease (n = 83) diagnosed between 1950 and 2002 were compared with 166 gender and age matched controls. Fracture histories were ascertained from each subject's medical records. Celiac disease is linked to an increased fracture risk before and after diagnosis. Before the index date, cases had a fracture rate twice that of controls (CI: 1.0-3.9, P = 0.045) and 2.5-fold greater after the index date (CI: 1.1-5.6, P = 0.026). Appendicular and axial fractures were 2.5 (CI: 0.9-6.5) and 3.2 times more likely (CI: 1.0-10.5) after the index date. These observations support a rationale for earlier detection of celiac disease, and active management of bone disease before bone effects have occurred, to reduce the persistent risk of fractures.

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Section: Discussionmentioning

confidence: 99%

Long-term Fracture Risk in Patients with Celiac Disease: A Population-Based Study in Olmsted County, Minnesota

et al. 2007

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“…17 -27 Instruction on age-appropriate intake of calcium, vitamin D, and the need for exercise to promote bone health should be provided during nutritional counseling at the time of diagnosis. 23 …”

Section: Introductionmentioning

confidence: 99%

Evidence-Informed Expert Recommendations for the Management of Celiac Disease in Children

et al. 2016

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Although the need for effective long-term follow-up for patients with celiac disease (CD) has been recognized by many expert groups, published practice guidelines have not provided a clear approach for the optimal management of these patients. In an attempt to provide a thoughtful and practical approach for managing these patients, a group of experts in pediatric CD performed a critical review of the available literature in 6 categories associated with CD to develop a set of best practices by using evidencebased data and expert opinion. The 6 categories included the following: bone health, hematologic issues, endocrine problems, liver disease, nutritional issues, and testing. Evidence was assessed by using standardized criteria for evaluating the quality of the data, grade of evidence, and strength of conclusions. Over 600 publications were reviewed, and 172 were chosen for inclusion. The thorough review of the results demonstrated that the quality of the data available was often insufficient to provide unequivocal best practices. However, using the available data and the clinical experience of the panel, a practical framework for the management of children with CD was created. These recommendations were developed by our expert panel and do not necessarily reflect the policy of the American Academy of Pediatrics. The potential usefulness of these best practices is underscored by the fact that consensus, measured by the outcome of anonymous voting, was reached by the panel for 24 of the 25 questions. We hope that these best practices may be useful to the pediatric gastroenterology and larger general pediatric communities.abstract

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“…GFD improves symptomology, reduces mucosal damage and eliminates risks for osteoporosis and bowel cancers associated with long term active CD [50][51][52][53][54][55][56]. All newly diagnosed patients should undergo a formal investigation for micronutrient deficiencies including serum iron, folic acid, vitamin D and vitamin B12 [40].…”

Section: Management Of Celiac Diseasementioning

confidence: 99%

Gluten and the Gut: A Brief Review of Gluten-Related Gastrointestinal Disorders

Shah¹

2017

SOJI

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We conducted online electronic searches (published manuscripts in English) of the Cochrane Library, pub med and manual searches of selected specialty journals to identify any pertinent literature. The search was conducted using the key words 'celiac disease', 'gluten related disorder', 'non celiac gluten sensitivity', 'wheat allergy', 'gluten', , 'gluten free diet'. Studies not published in English or published only in the abstract form were excluded. We also conducted a focused review of available references to identify subsequent pertinent papers. AbstractCeliac disease (CD) was the first gluten-related disorder to be described. Presently the realm of gluten-related disorders also includes non-celiac gluten sensitivity (NCGS) and wheat allergy (WA). CD is a multisystem immune mediated enteropathy observed in genetically susceptible individuals exposed to dietary gluten present in barley, rye and wheat. Although the prevalence of CD is on the rise, it still largely remains under diagnosed given that many cases can be silent, subtle or atypical. The Pathophysiology of CD includes both innate and adaptive immune response to dietary gluten. Patients present with a wide variety of intestinal and extra-intestinal symptoms and are at risk for non-Hodgkin's lymphoma and small intestinal adenocarcinoma. The corner stone for treatment of CD is a gluten-free diet (GFD). NCGS is an emerging condition associated with gluten ingestion and the diagnosis of which is based on exclusion of CD and WA. Further evidence and studies are required to fully appreciate the clinical entity of NCGS and WA to detail its epidemiology and pathogenesis. The symptoms of NCGS and WA may overlap with CD and hence it is imperative to differentiate these clinical entities and select patients for appropriate management.Keywords: Celiac disease, gluten related disorder, non-celiac gluten sensitivity, wheat allergy, gluten, epidemiology, clinical features, Pathophysiology, management, gluten free diet.Core tip: CD is largely under-diagnosed while the incidence and prevalence of gluten-related disorders are on the rise. A clear understanding of the various clinical presentations of gluten-related disorders can help differentiate CD from NCGS and WA. The management for these conditions differs and hence accurate diagnosis leads to improved patient outcomes with avoidance of longterm complications as well as unnecessary testing which can be both invasive and expensive. Celiac DiseaseThe term celiac is derived from the Greek word "koiliaks" meaning "abdominal". It was first described in the second century in modern day Turkey by a Greek physician Aretaeus of Cappadocia [1]. In 1888, Samuel Gee; a pediatrician from the United Kingdom gave the first modern-day description of the condition and associated diet to the treatment of celiac disease EpidemiologyCeliac disease occurs in about 1% of the general population worldwide [7]. Data from the USA suggests CD to be more common in Caucasians as compared to African-Americans and Hispanics [8,9]. The initial ...

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Restoration of Body Composition in Celiac Children after One Year of Gluten-Free Diet

Cited by 68 publications

References 7 publications

Long-term Fracture Risk in Patients with Celiac Disease: A Population-Based Study in Olmsted County, Minnesota

Long-term Fracture Risk in Patients with Celiac Disease: A Population-Based Study in Olmsted County, Minnesota

Evidence-Informed Expert Recommendations for the Management of Celiac Disease in Children

Gluten and the Gut: A Brief Review of Gluten-Related Gastrointestinal Disorders

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