scholarly journals Quantitative histology-based classification system for assessment of the intestinal mucosal histological changes in patients with celiac disease

2019 ◽  
Vol 17 (3) ◽  
pp. 387-397 ◽  
Author(s):  
Prasenjit Das ◽  
Gaurav PS Gahlot ◽  
Alka Singh ◽  
Vandana Baloda ◽  
Ramakant Rawat ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Classification System ◽  
Histological Changes ◽  
Quantitative Histology

scholarly journals Frequency of Celiac Disease in Children Presented with Liver Disease at a Tertiary Care Center

2017 ◽  
Vol 40 (3) ◽  
pp. 144-148
Author(s):  
Faika Hussain ◽  
ASM Bazlul Karim ◽  
Md Rukunuzzaman ◽  
Syeda Afria Anwar ◽  
Kaniz Sultana ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Liver Disease ◽  
Tissue Transglutaminase ◽  
Care Center ◽  
Tertiary Care ◽  
Chronic Inflammatory Disease ◽  
Multisystem Disease ◽  
Cross Sectional ◽  
Histological Changes ◽  
Positive Group

Background: Celiac disease is (CD) a genetically determined chronic inflammatory disease induced by an environmental precipitant. It is a multisystem disease and can develop at any point of time during life in genetically susceptible individuals upon ingestion of wheat gluten and related cereal proteins. The onset of symptoms in the atypical form generally occurs between 4-15 years of age. Diagnosis of CD with extraintestinal manifestations is frequently missed as it presents without diarrhoea.Objective: To observe the frequency of celiac disease in children with liver disease.Methods: This cross sectional study was conducted at BSMMU from January 2014 to June 2015. A total of 59 children (age 18 months to16 years) with clinical and biochemical features of liver disease were initially enrolled for the study. Their clinical history, examination findings and investigation reports were recorded in a data collection sheet and informed consent was obtained from parents. Routine investigations, liver function tests, tissue transglutaminase tTG (IgA), total IgA. were done. After exclusion of other causes of liver disease endoscopy of upper gastrointestinal tract (GIT) was done on patients who were tTG (titer of >50 iu/mL) positive. Patients who were tTG negative but found IgA deficient (1 patient) was also selected for upper GI endoscopy and biopsy fragments were taken from second part of duodenum (D2) sent for histopathology.Results: Mean age of studied children was 8.33 ± 3.64 years. Out of 59 children with liver disease, 32.2% were tTG positive of whom female were 8 (13.6%) and male 11 (18.6%). Mean age at diagnosis of all patients with tTG positive group was 8.24 ± 2.78 (range 4-12) years. Among 19 sero-positive patients, short stature was found in 57.9% children. Mean Hb level in tTG positive group was 8.83 ± 2.64 gm/dl and in tTG negative group (10.27 ± 1.74 gm/dl). Sixteen (84.2%) out of 19 tTG positive patients had raised S. ALT. Out of 19 tTG positive children, endoscopy was done in 15 cases (endoscopy could not be done in 4 patients due to persistently raised PT) along with 1 patient who was IgA deficient. Endoscopic changes were mosaic and scalloping of D2 mucosa in 1 and 2 cases respectively. Histological changes compatible with CD were found in 5 (31.3%) patients. Marsh 3a category was found in 2 (12.5%) cases and 3b in 3 (18.8%) cases.Conclusion: In the present study, 32.2% liver disease cases were found tTG positive. Histological changes compatible with CD were found in about one-third cases. Screening for celiac disease may be included in the diagnostic tests for evaluation of liver disease in children.Bangladesh J Child Health 2016; VOL 40 (3) :144-148

scholarly journals The Evolving Landscape of Biomarkers in Celiac Disease: Leading the Way to Clinical Development

2021 ◽  
Vol 12 ◽  
Author(s):  
Glennda Smithson ◽  
Jenifer Siegelman ◽  
Toshihiko Oki ◽  
Joseph R. Maxwell ◽  
Daniel A. Leffler
Keyword(s):  
Celiac Disease ◽  
Peripheral Blood Cell ◽  
Clinical Development ◽  
Intestinal Damage ◽  
Gluten Free ◽  
Histological Changes ◽  
Specific Patient ◽  
Cell Responses ◽  
Immune Mediated ◽  
Duodenal Biopsies

Celiac disease is a common immune-mediated disease characterized by abnormal T-cell responses to gluten. For many patients, symptoms and intestinal damage can be controlled by a gluten-free diet, but, for some, this approach is not enough, and celiac disease progresses, with serious medical consequences. Multiple therapies are now under development, increasing the need for biomarkers that allow identification of specific patient populations and monitoring of therapeutic activity and durability. The advantage of identifying biomarkers in celiac disease is that the underlying pathways driving disease are well characterized and the histological, cellular, and serological changes with gluten response have been defined in gluten challenge studies. However, there is room for improvement. Biomarkers that measure histological changes require duodenal biopsies and are invasive. Less invasive peripheral blood cell and cytokine biomarkers are transient and dependent upon gluten challenge. Here, we discuss established biomarkers and new approaches for biomarkers that may overcome current limitations.

scholarly journals Acrodystrophic axonal polyneuropathy with celiac disease: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
S. N. Bardakov ◽  
Minh Duc Tran ◽  
S. V. Lapin ◽  
A. N. Moshnikova ◽  
E. U. Kalinina ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Immunosuppressive Treatment ◽  
Gastrointestinal Symptoms ◽  
Lower Extremities ◽  
Duodenal Mucosa ◽  
Extraintestinal Manifestations ◽  
Histological Changes ◽  
Treatment Protocols ◽  
Axonal Polyneuropathy ◽  
Wide Range

Abstract Background Patients with celiac disease present with not only gastrointestinal symptoms but also extraintestinal manifestations such as anemia, osteopathy, dermatitis herpetiformis, and celiac neuropathy. Despite a fairly wide range of celiac neuropathies, we report a case of the acrodystrophic variant of celiac polyneuropathy, which has not been previously described. Case presentation A 41-year-old Ukrainian male suffered from symmetric, sensorimotor axonal polyneuropathy and encephalopathy associated with celiac disease, which is characterized by severe trophic disorders in the lower extremities (trophic ulcers, hyperkeratosis, and anhidrosis). Acrodystrophic changes in the lower extremities were due to both neurogenic and direct immunoinflammatory damaging effects. Clinical–electrophysiological dissociation was also noted, which was represented by a gross axonal lesion with the preservation of muscle strength. The absence of enteropathic manifestations was accompanied by the pronounced histological changes in the duodenal mucosa by IIIb stage of Marsh. A gluten-free diet in combination with membrane plasma exchange and intravenous pulse methylprednisolone was prescribed to reduce the severity of sensory disorders and regression of encephalopathy within 7 months. Conclusion Celiac disease may be a potential cause of neuropathy and encephalopathy in adult patients. Further immunosuppressive treatment protocols for both intestinal and extraintestinal manifestations of celiac disease are required.

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