Incidence Of Celiac Disease Research Articles

Juvenil İdiopatik Artrit Hastalarında Çölyak Hastalığı ve Çölyak Dışı Gluten Duyarlılığı Taraması

INTRODUCTION: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children characterized by autoimmune etiology. In previous studies, increase In the Incidence of celiac disease (CD) was reported in patients diagnosed with JIA. In this study, the presence of CD and non-celiac gluten sensitivity (NCGS) in patients diagnosed with JIA were investigated. METHODS: Sixty-one (57.3%) JIA patients admitted to the pediatric rheumatology outpatient clinic between January 2020 and April 2020 were included in this cross-sectional study. All patients were evaluated with clinical and laboratory findings in terms of CD and NCGS. Total immunoglobulin (Ig)-A, tissue transglutaminase antibody (tTG) IgA and IgG, anti-endomysium-antibody (EMA) IgA and IgG and anti-gliadin-antibody (AGA) IgA and IgG levels were measured in all patients. RESULTS: Sixty-one JIA patients Including 35 girls, were enrolled in the study. The mean age of the patients was 11.4±4.6 years, the mean age at diagnosis was 10.2±3.4 years. Patients were diagnosed with oligoarticular JIA (n=33), enthesitis-related arthritis (n=18), polyarticular JIA (n=8), and psoriatic arthritis (n=2). All patients were using disease-modifying antirheumatic drugs during the study. Thirty-five patients were receiving biological therapy, concomitantly. The patients (n=2) had abdominal pain, indigestion (n=2), and constipation (n=2). None of the patients had growth retardation. EMA IgA and IgG, tTG IgA and IgG, AGA IgA and IgG tests were negative in all patients. DISCUSSION AND CONCLUSION: CD and NCGS were not detected in our JIA patients. Multicenter studies may guide the clinicians about the circumstances to perform CD and NCGS screening in JIA patients.

Chatbot Design for a Healthy Life to Celiac Patients: A Study According to a New Behavior Change Model

There is an absolute need for technology in our daily life that makes people busy with their smartphones all day long. In the healthcare field, mobile apps have been widely used for the treatment of many diseases. Most of these apps were designed without considering health behavior change models. Celiac disease is a significant public health problem worldwide. In Saudi Arabia, the incidence of celiac disease is 1.5%. Celiac patients have a natural demand for resources to facilitate care and research; however, they have not received much attention in the field of healthcare apps. This study introduced a new health behavior change model based on the existing common models and adapted it to the use of technology for the changing behavior of celiac patients towards healthy suitable food. As proof of concept, the new model was applied to the WhatsApp chatbot for patients with celiac disease. To test the impact of the chatbot, 60 Saudi celiac patients participated in three steps. First, they completed a pre-test questionnaire. Then, the participants were divided into two groups: the control group, which was left without any intervention, and the test group, who used the chatbot for 90 days. Finally, all participants completed the post-test questionnaire. The results confirmed a significant statistical difference between both groups, and the test group improved their healthy life in terms of eating habits, reduced celiac symptoms, and commitment to the treatment plan.

Retrospective Study of Tissue Transglutaminase Antibody Levels in Celiac Disease-Suspected Patients at Tertiary Care Hospital in Uttarakhand

Introduction: Celiac disease (CD) is a chronic gastrointestinal disorder arising due to gluten sensitivity in susceptible individuals. In India, one person per 100 is suffering from this disease. CD has been reported more in high wheat-consuming areas like northern India. However, the incidence of CD in patients attending tertiary care hospital of Uttarakhand has not yet been reported. Therefore, this study was planned. Materials and Methods: A retrospective study with 603 patients was done at AIIMS Rishikesh in Biochemistry Department. These patients were screened for CD by tissue transglutaminase antibodies (ttgA) levels using enzyme-linked immunosorbent assay method. Percentage of levels of ttgA <4 U/ml (normal value) and >4U/ml in male, female adults, and children was calculated. Chi-square test was applied to compare results. Results: Out of 603 patients, 23 (3.81%) had abnormally raised ttgA levels (>4 U/ml). Percentage (15.18%) of ttgA levels in male children was significantly (P = 0.01) higher than 2.56% in female children. Mean + standard deviation (SD) of normal and abnormal ttgA levels in patients was 1.17 + 0.45 versus 66.81 + 34.80 U/ml, respectively. Mean + SD of abnormal ttgA levels in children and adults was 72.84 + 41.91 versus 32.38 + 24.75 U/ml, respectively. There was a statistically significant difference in abnormal ttgA levels among children and adults with children predominantly being higher (P = 0.0235). Conclusion: This study shows that levels of ttgA suggestive of CD in children are higher as compared to adults and more in males than females attending tertiary care hospital of Uttarakhand.

Celiac disease in the COVID-19 pandemic

BackgroundThe COVID-19 pandemic has had an impact on global health. DesignThe impact of the COVID-19 pandemic on patients with coeliac disease was assessed in the present review. ResultsThe incidence of coeliac disease and the problems associated with coeliac disease increased during the COVID-19 pandemic. Adherence to the diet is crucial for the patient's health and quality of life since the only approved therapy for coeliac disease is a gluten withdrawal. ConclusionsA gluten-free diet should be promoted by the therapeutic team and implemented among these categories of patients.

Simposio 8: Nutrición en diabetes y enfermedad celíaca

Simposio 8: Tratamiento nutricional de la diabetes: nuevos horizontesNutrición en diabetes y enfermedad celíacaLa asociación genética existente entre diabetes mellitus (DM1) y enfermedad celíaca (EC) llevó a hipotetizar un posible mecanismo de daño tisular autoinmunitario común e, incluso, una posible intolerancia a antígenos presentes en la dieta como mecanismo etiológico de ambas enfermedades. En los últimos años se observó un aumento en la incidencia tanto de DM1 como de EC. Más del 90% de los individuos con EC y entre 60-70% de los DM1 expresan el mismo antígeno HLA DQA1*0501 y DQB1*0201. La EC puede hallarse en estado silente o subclínico en los DM1 en proporciones que varían entre 1 y 16%. La prevalencia de EC en pacientes con DM1 oscila entre el 1 y el 8%.

Evaluation of Daily Lives of Children and Adolescents with Celiac Disease and Nursing Approaches

The incidence of celiac disease has been increasing in recent years. Celiac disease is an autoimmune enteropathy that emerges mostly in the childhood period. This disorder is a chronic condition of the small intestine due to gluten intake in individuals with genetic predisposition. In the treatment of celiac disease, gluten-free diet therapy is applied. However, the adaptation process to the diet may create difficulties for patients. Compliance with diet is much more difficult among patients with celiac disease in childhood and adolescence than in adult patients. Children and adolescents face distinct difficulties in their homes, at school, and in their social lives. Besides following dietary treatment, children and adolescents living with celiac disease need peer support to manage their daily routines. In this article, we aimed to discuss the problems experienced by children and adolescents living with celiac disease and nursing approaches to these problems.

Incidence of Celiac Disease in Down Syndrome: A Longitudinal, Population-Based Birth Cohort Study.

American Academy of Pediatrics (AAP) guidelines for children with Down syndrome (DS) include assessment for celiac disease (CD), although data to support this recommendation have been inconsistent. We determined the incidence of CD among children with DS in a population-based birth cohort of children born from 1976 to 2000 in Olmsted County, Minnesota. Individuals with karyotype-confirmed DS and CD (using diagnosis codes, positive serology, and duodenal biopsies) were identified. The incidence of CD in DS was compared with the published incidence of CD for Olmsted County residents (17.4 [95% confidence interval = 15.2-19.6] per 100 000 person-years). Among 45 individuals with DS from the birth cohort, 3 (6.7%) were identified with positive celiac serology and confirmatory biopsies at ages 9, 12, and 23 years, for an incidence of 325 per 100 000 person-years. Thus, individuals with DS have more than 18 times the incidence rate of CD compared with the general population, supporting the AAP guidelines.

Punjabis and Coeliac Disease: A Wake-Up Call

Punjabis are one of the largest ethnic groups in the world, with at least 124 million members. Their diet is based around wheat cereals and they are now recognised to be at risk of coeliac disease. Indeed, the incidence of coeliac disease amongst Punjabi migrants is three times that of other Europeans, suggesting that in excess of 3 million Punjabi people may be affected by the condition. This review considers the history of coeliac disease and its lack of ready diagnosis in the Punjabi community, including the adverse outcomes as a result. It considers the poor-quality information available to Punjabi patients and tentatively suggests methods of dealing with these issues.

Celiac Disease and Obesity: Is Bariatric Surgery an Option?

Celiac disease is an immune-mediated enteropathy associated with malabsorptive syndrome and fat-soluble vitamin deficiencies. Celiac disease affects 1% of individuals but is largely underdiagnosed, as its multifaceted clinical presentations create challenging diagnostic scenarios. With the rise of the obesity epidemic, doctors are increasingly seeing celiac disease patients with overweight or obesity, which raises the question of bariatric surgery. However, few studies so far have investigated bariatric surgery in this patient population. Here, we provide a comprehensive review of the literature on celiac disease, its nutritional consequences and complications, and we discuss the possible impact of bariatric surgery on weight loss, nutritional deficiencies, response to gluten-free diet, and long-term post-operative complications. We also review the effect of bariatric surgery on the incidence of celiac disease.

Celiac Disease in Children with Short Stature (Incidence and Morphometric Study)

A study was aimed to determine the incidence of celiac disease (CD) and to make morphometric analysis of duodenal biopsy in children already diagnosed as a short stature in Mosul city. One hundred and seventy seven children aged between 3-17 years with short stature were examined. Their age, gender, serum antitransglutaminase antibody; and small intestinal biopsy were taken. The changes in the biopsy were evaluated and graded by by Corazza and Villanacci grading system. Short stature children serologically positive for celiac disease were only subjected to small intestinal biopsy. Results revealed that most predominate age group were those between 11-17 years (mean 11.8 years), with a higher male gender (107/177, 60.4%0 than female (70/177, 39.6%). Of these CD represents in 54 out of 177 children, with a grade B (b) was the predominant one (24 out from 54)(44.5%). In conclusion, short stature can be the only symptom for celiac disease in children aged between 7-11 years with higher tendency in male than female. The health significance of short stature is to subject children to intestinal biopsy for celiac disease confirmation.

Incidence of Celiac Disease Is Increasing Over Time: A Systematic Review and Meta-analysis.

To conduct a systematic review and meta-analysis that defines the worldwide incidence of celiac disease (CD) and examines temporal trends. MEDLINE and EMBASE were searched for population-based studies reporting the incidence of CD in the overall population, children, or adults. No limits were placed on year or language of publication. Studies solely examining at-risk populations (e.g., patients with type 1 diabetes) were excluded. Random-effects models were performed to meta-analyze sex- and age-specific incidence in the 21st century. Temporal trend analyses assessed the average annual percent change in CD incidence over time. Of 11,189 citations, 86 eligible studies were identified for inclusion, of which 50 were deemed suitable for analyses. In the 21st century, the pooled female incidence of CD was 17.4 (95% confidence interval [CI]: 13.7, 21.1) (I = 99.5%) per 100,000 person-years, compared with 7.8 (95% CI: 6.3, 9.2) (I = 98.6%) in males. Child-specific incidence was 21.3 per 100,000 person-years (95% CI: 15.9, 26.7) (I = 99.7%) compared with 12.9 (95% CI: 7.6, 18.2) (I = 99.9%) in adults. Pooling average annual percent changes showed the incidence of CD to be increasing by 7.5% (95% CI: 5.8, 9.3) (I = 79.6%) per year over the past several decades. Incidence of CD is highest in females and children. Overall, the incidence has been significantly rising in the latter half of the 20th century and into the 21st century throughout the Western world. Population-based studies in Africa, Asia, and Latin America are needed to provide a comprehensive picture of the global incidence of CD.

The role of nutritional factors and food allergy in the development of psoriasis

Psoriasis is a chronic relapsing disease that affects about 2% of the world's population and leads to medical and social losses. There is evidence of the effect of nutritional factors on the course of psoriasis in modern literature. The aim of the research was to analyze modern domestic and foreign literature on the role of nutritional factors, food allergies and the state of the gastrointestinal tract in the etiopathogenesis of psoriasis Material and methods. The electronic resources were used in preparing the article: the PubMed/MEDLINE portal, "Scientific Electronic Library eLIBRARY.RU". The following filters and keywords were requested: psoriasis and nutrition, food allergies and psoriasis, gastrointestinal manifestations and psoriasis, diet and psoriasis, obesity and psoriasis. Results and discussion. The role of nutrition as a predictor of the development of psoriatic skin rashes and exacerbation of the disease has been discussed. The mechanisms of the positive influence of the correction of metabolic disorders on skin processes in patients with psoriasis have been analyzed. It has been noted that further studies are needed to study the effectiveness of a lowcalorie diet for psoriasis treatment. Particular attention has been paid to the role of food allergy and pathology of the gastrointestinal tract in the etiopathogenesis of psoriatic disease. It is noted that in patients with psoriasis, structural and functional disorders in the gastrointestinal tract are observed, which lead to metabolic changes, endotoxinemia and autosensitization of the body. The role of intolerance to certain foods in the development of psoriasis has been discussed. Most of the available data indicate a high incidence of celiac disease and gluten intolerance in patients with psoriasis, however, information about the effectiveness of a gluten-free diet is controversial. Attention is drawn to the "non-celiac gluten sensitivity" associated with psoriasis, which represents a syndrome of neither allergic nor autoimmune genesis, which is manifested by gluten intolerance and characterized by symptoms similar to celiac disease. An increase in the frequency of occurrence of a high concentration of specific IgE to potato and carrot allergens in patients with psoriasis is noted, which most likely reflects cross-reactions with pollen allergens. An interesting hypothesis is the discussion of a lesion of the gastrointestinal tract in the presence of food allergies in patients with psoriasis, which may be a reflection of the systemic dermatogastrointestinal process and manifest psoriatic rashes on the skin. The mechanism of the anti-inflammatory effect associated with adhering to the Mediterranean diet for psoriasis is described in detail. Conclusion. The data presented allow us to consider the role of nutrition in the etiopathogenesis of psoriasis as significant, both from the point of view of the influence of nutritional factors and food allergens, that must be taken into account when prescribing therapeutic nutrition and elimination diet in combination with standard systemic therapy.

Current Concepts of Dermatitis Herpetiformis.

Dermatitis herpetiformis (DH) is an autoimmune skin disease that causes itchy, blistering rash, typically on the elbows, knees and buttocks. DH and coeliac disease share the same genetic background, glutendependent enteropathy and antibody response against tissue transglutaminase. DH is currently considered a cutaneous manifestation of coeliac disease, and the prevailing hypothesis is that DH develops as a late manifestation of subclinical coeliac disease. The incidence of DH is decreasing contemporarily with the increasing incidence of coeliac disease. The IgA immune response in DH skin is directed against epidermal transglutaminase, while the autoantigen in the gut is tissue transglutaminase. Granular IgA deposition in the papillary dermis is pathognomonic for DH, and is a finding used to confirm the diagnosis. The treatment of choice for DH is a life-long gluten-free diet, which resolves the rash and enteropathy, increases quality of life, and offers a good long-term prognosis.

Autoimmune and Allergic Disorders are More Common in People With Celiac Disease or on a Gluten-free Diet in the United States.

We analyzed demographics, lifestyle patterns, and clinical characteristics of people with celiac disease (CD) and people without CD avoiding gluten (PWAG) to better understand associations with medical conditions and consumer behavior. Clinical significance of CD and gluten avoidance in the general population is incompletely understood. Recently, a high incidence of CD in adolescents with susceptibility genotypes, similar to other autoimmune or allergic disorders, and regional differences in consumer practices of gluten avoidance were reported. Among 22,277 participants in the National Health and Nutrition Examination Survey 2009-2014, we identified persons with CD by testing CD serology or by both a health care provider diagnosis and adherence to a gluten-free diet. Similarly, PWAG were defined as adherent to a gluten-free diet without a CD diagnosis. Consumer behavior and characteristics of both groups, CD and PWAG were compared with those without these conditions, using survey-weighted generalized logistic regression. Participants with CD considered nutrition very important when grocery shopping and tended to have more constipation and thyroid disease. PWAG tended to spend more money on groceries, purchase organic foods, and check food labels more frequently during grocery shopping. They also reported having more food allergies, asthma, and thyroid disease. Our study confirms that CD and PWAG share comorbidities of autoimmune nature. PWAG had more autoimmune/allergy-related disorders that may be associated with non-celiac gluten sensitivity a self-justifiable reason to be on the diet.

1198 Temporal Trends of Acute Myocardial Infarction-Related Hospitalizations in Celiac Disease Patients

INTRODUCTION: Celiac disease (CD) is a chronic autoimmune inflammatory disease of small bowel. There is availability of mixed data about influence of CD on the incidence of Acute Myocardial Infarction (AMI). Some studies have suggested that patients with CD have a worse atherosclerotic profile due to the underlying inflammatory state and restriction of whole grains in their diet. We aimed to evaluate temporal trends of incidence and mortality of CD + AMI hospitalizations in the largest nationally representative sample. METHODS: We reviewed Nationwide Inpatient Sample from 2005-2014 for adult AMI hospitalizations (includes ST elevation and Non ST elevation MI) as a principal diagnosis with CD as the secondary diagnosis by using validated ICD9-CM codes. We examined the annual trends in the number of cases and hospitalization charges yearly and used survey regression to calculate adjusted odds ratios (aOR) for hospital mortality and other outcomes. RESULTS: We identified a total of 61,80,485 AMI hospitalizations from 2005-2014 of which 3169 had a diagnosis for CD. The proportion of patients with CD in AMI hospitalizations increased from 0.015% in 2005 to % 0.076% in 2014 (Figure 1). CD + AMI hospitalizations were significant (P < 0.02) for being older (70.3 vs. 67.4 years), more female (51.9% vs. 39.5%); higher proportion of whites (93.8% vs. 76.6%; P < 0.01) and more prevalent in the Northeast (28.7% vs 19.5%) and West (21.0% vs 17.5%) United States. After adjusting for age, gender, race, Charlson Comorbidity index and hospital level characteristics, CD + AMI hospitalizations had lower odds-ratio for hospital mortality (aOR = 0.39; 95% CI = 0.23-0.67; P < 0.01). Length of stay in the CD + AMI patients was shorter (4.53 vs 4.84 days, P < 0.01) but the mean hospitalization charges was higher ($64058 vs $60223, P < 0.01), as compared to non-CD AMI patients. CONCLUSION: The results of our study provide valuable epidemiological data about the occurrence of AMI in CD patients. We found that the number of AMIs in the CD patients has risen more than five-fold from 2005-2014. However, the odds of in-hospital mortality in these patients is lower than the patients without CD for unknown reasons. The results of our study add to the current literature that though the CD-related systemic inflammation is associated with an increasing number of AMI hospitalization but these patients have comparably favorable outcomes than controls.

Cystic fibrosis transmembrane conductance regulator (CFTR) and autophagy: hereditary defects in cystic fibrosis versus gluten-mediated inhibition in celiac disease.

Cystic Fibrosis (CF) is the most frequent lethal monogenetic disease affecting humans. CF is characterized by mutations in cystic fibrosis transmembrane conductance regulator (CFTR), a chloride channel whose malfunction triggers the activation of transglutaminase-2 (TGM2), as well as the inactivation of the Beclin-1 (BECN1) complex resulting in disabled autophagy. CFTR inhibition, TGM2 activation and BECN1 sequestration engage in an ‘infernal trio’ that locks the cell in a pro-inflammatory state through anti-homeostatic feedforward loops. Thus, stimulation of CFTR function, TGM2 inhibition and autophagy stimulation can be used to treat CF patients. Several studies indicate that patients with CF have a higher incidence of celiac disease (CD) and that mice bearing genetically determined CFTR defects are particularly sensitive to the enteropathogenic effects of the orally supplied gliadin (a gluten-derived protein). A gluten/gliadin-derived peptide (P31–43) inhibits CFTR in mouse intestinal epithelial cells, causing a local stress response that contributes to the immunopathology of CD. In particular, P31–43-induced CFTR inhibition elicits an epithelial stress response perturbing proteostasis. This event triggers TGM2 activation, BECN1 sequestration and results in molecular crosslinking of CFTR and P31-43 by TGM2. Importantly, stimulation of CFTR function with a pharmacological potentiator (Ivacaftor), which is approved for the treatment of CF, could attenuate the autophagy-inhibition and pro-inflammatory effects of gliadin in preclinical models of CD. Thus, CD shares with CF a common molecular mechanism involving CFTR inhibition that might respond to drugs that intercept the "infernal trio". Here, we highlight how drugs available for CF treatment could be repurposed for the therapy of CD.

Dermatitis herpetiformis.

Dermatitis herpetiformis (DH) is a cutaneous manifestation of coeliac disease (CD), which causes an itching and blistering rash, typically on the elbows, knees and buttocks. DH and CD share a similar genetic background, small bowel mucosal alterations, and an autoimmune response against tissue transglutaminase in the serum and small bowel. DH is typically diagnosed during adulthood, and it is slightly more common among males than females. The incidence of DH seems to be decreasing, in contrast to the detected four-fold increase in the incidence of CD. In addition to typical clinical picture, diagnosis of DH relies on the demonstration by direct immunofluorescence of pathognomonic granular IgA deposits in the papillary dermis. Circulating tissue transglutaminase antibodies support the diagnosis, but their absence does not exclude DH. Obtainment of small bowel mucosal biopsies is not necessary when DH is diagnosed, but if performed, the majority of patients are found to have villous atrophy, and even those with normal villous architecture evince CD-type inflammation. The treatment of choice in DH is a strict, life-long adherence to a gluten-free diet (GFD). In addition to alleviating the symptoms of DH and healing the small bowel mucosal damage, a GFD increases the quality of life for patients, and decreases the risk for lymphoma in DH. Further, the mortality rate of patients with DH treated with a GFD seems to be lower than that of the general population. However, as changing to a GFD has a rather slow effect on the DH rash, patients with severe skin symptoms should additionally be treated with dapsone medication. This review article is based on a presentation given at the British Society for Medical Dermatology blistering skin diseases meeting 2019.

Mo2000 – Incidence of Celiac Disease is Increasing Over Time: A Systematic Review and Meta-Analysis

Mo2000 – Incidence of Celiac Disease is Increasing Over Time: A Systematic Review and Meta-Analysis

Mo1994 – Is the Increase in Celiac Disease Incidence Due to a Birth Cohort Or Time Period Effect?: A Population Based Study

Mo1994 – Is the Increase in Celiac Disease Incidence Due to a Birth Cohort Or Time Period Effect?: A Population Based Study

The Underdiagnosed Enemy: Africa Goes Celiac?

Celiac disease incidence is continuously increasing worldwide and in Africa, where a clear North to South gradient is apparent. At least in the Maghreb region, the disease features resemble its European neighbors, but some aspects are completely different. The present review highlights the underdiagnosis and the inadequate nutritional therapy for celiac disease patients and summarizes the local special circumstances that should be address to coop with the contemporary load and future burden of the disease.