Splenic volume differentiates complicated and non‐complicated celiac disease

Gils, Tom van; Nijeboer, Petula; Waesberghe, J.H.T. van; Coupé, Veerle M.H.; Janssen, Kiki; Zegers, Jessy A.; Nurmohamed, Shaikh A.; Kraal, Georg; Jiskoot, S. C. I.; Bouma, Gerd; Mulder, Chris J.

doi:10.1177/2050640616663571

Cited by 12 publications

(5 citation statements)

References 33 publications

(91 reference statements)

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“…Measuring spleen size is of interest in case of suspected/confirmed CD, as some small-sampled studies have linked splenic hypotrophy with CD and other have shown an association of small spleen volume with refractory CD [58,59,60].…”

Section: Hyposplenism and Susceptibility To Infectionsmentioning

confidence: 99%

Hematologic Manifestations in Celiac Disease—A Practical Review

et al. 2019

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Celiac disease (CD) is a systemic autoimmune disease driven by gluten-ingestion in genetically predisposed individuals. Although it primarily affects the small bowel, CD can also involve other organs and manifest as an extraintestinal disease. Among the extraintestinal features of CD, hematologic ones are rather frequent and consist of anemia, thrombocytosis (thrombocytopenia also, but rare), thrombotic or hemorrhagic events, IgA deficiency, hyposplenism, and lymphoma. These hematologic alterations can be the sole manifestation of the disease and should prompt for CD testing in a suggestive clinical scenario. Recognition of these atypical, extraintestinal presentations, including hematologic ones, could represent a great opportunity to increase the diagnostic rate of CD, which is currently one of the most underdiagnosed chronic digestive disorders worldwide. In this review, we summarize recent evidence regarding the hematological manifestations of CD, with focus on practical recommendations for clinicians.

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Section: Hyposplenism and Susceptibility To Infectionsmentioning

confidence: 99%

Hematologic Manifestations in Celiac Disease—A Practical Review

et al. 2019

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“…Imaging studies may also aid disclosing abdominal masses and mesenteric lymphadenopathies (27, 38), heralding RCD-II and EATL-related complications (Table 1). Splenic atrophy is a further finding, especially in cases of RCD-II and EATL (39). Endoscopic studies should be integrated with biopsy sampling and histological re-evaluation.…”

Section: Diagnostic Workup Of Rcdmentioning

confidence: 99%

“…Laboratory tests are non-specific with anemia, high LDH and B2M levels and low serum albumin due to starvation (30,95). Imaging studies often reveal enteric strictures, perforations or mass lesions, as well as mesenteric adenopathies and/or splenomegaly (27,39). Although these findings are highly suggestive of EATL in the setting of CD, a definite diagnosis is only posed by histological evaluation of endoscopic biopsies or resection specimens.…”

Section: Clinical-prognostic Features Of Eatlmentioning

confidence: 99%

Refractory celiac disease and its mimickers: a review on pathogenesis, clinical-pathological features and therapeutic challenges

Scarmozzino,

Pizzi,

Pelizzaro

et al. 2023

Front. Oncol.

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Refractory celiac disease (RCD) and enteropathy-associated T-cell lymphoma (EATL) are rare, yet severe complications of celiac disease (CD). Over the last decades, several studies have addressed the biology and clinical-pathological features of such conditions, highlighting unique disease patterns and recurrent genetic events. Current classification proposals identify two forms of RCD, namely: (i) type 1 RCD (RCD-I), characterized by phenotypically normal intra-epithelial lymphocytes (IELs); and (ii) type 2 RCD (RCD-II), featuring phenotypically aberrant IELs. While RCD-I likely represents a gluten-independent dysimmune reaction against small bowel epithelial cells, RCD-II is better considered an in situ aggressive T-cell lymphoma, with high rates of progression to overt EATL. The diagnosis of RCD and EATL is often challenging, due to misleading clinical-pathological features and to significant overlap with several CD-unrelated gastro-intestinal disorders. Similarly, the treatment of RCD and EATL is an unmet clinical need for both gastroenterologists and hematologists. Moving from such premises, this review aims to provide a comprehensive view of RCD and EATL, specifically considering their pathogenesis and the many still open issues concerning their diagnosis and clinical management.

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“…Hyposplenism is more common with concomitant autoimmune disease, old age at coeliac diagnosis, refractory coeliac disease or a history of major infections 127 . Reduced spleen volume on imaging is a marker for refractory coeliac disease 131 . As coeliac patients who have not had pneumococcal vaccination are at increased risk of community‐acquired pneumonia, 132 vaccination against pneumococcus is recommended and vaccination against the other main encapsulated bacteria Neisseria meningitidis and Haemophilus influenzae type B should be considered.…”

Section: Monitoring For Complicationsmentioning

confidence: 99%

Review article: Follow‐up of coeliac disease

Tye–Din

2022

Aliment Pharmacol Ther

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Coeliac disease is a lifelong immune-mediated enteropathy associated with important systemic manifestations. 1,2 A strict gluten-free diet (GFD) is the cornerstone of management but does not resolve the underlying immune cause of coeliac disease. 3 The GFD imparts a substantial treatment burden, 4 and many patients fail to achieve complete symptom or mucosal remission. As coeliac disease is associated with increased morbidity and modestly increased mortality, periodic medical follow-up is considered a crucial component of patient care [5][6][7][8] but this is compromised by the paucity of evidence to inform best-practice approaches. 9,10 As a result, real-world follow-up is often inconsistent or absent altogether. [11][12][13] For many chronic illnesses, such as type 1 diabetes, the importance of maintaining long-term follow-up to assess disease status, treatment efficacy and monitor for complications is well established in the medical community, however, for coeliac disease, this is typically not the case, even though the monitoring goals are the same. 5,6,7,8,14 For patients, the key goals of treatment are to resolve symptoms, reduce the risk of complications and achieve optimal quality of life, and for clinicians, disease remission also encompasses healing of the enteropathy. Effective models of care that leverage local medical and allied health expertise, ideally involving a gastroenterologist, dietitian and primary care provider, will support these goals but willThe Handling Editor for this article was Professor Peter Gibson, and it was accepted for publication after full peer-review.

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Splenic volume differentiates complicated and non‐complicated celiac disease

Cited by 12 publications

References 33 publications

Hematologic Manifestations in Celiac Disease—A Practical Review

Hematologic Manifestations in Celiac Disease—A Practical Review

Refractory celiac disease and its mimickers: a review on pathogenesis, clinical-pathological features and therapeutic challenges

Review article: Follow‐up of coeliac disease

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