Post by kickingfrog on Feb 3, 2011 12:57:29 GMT
From Charlotte
Grown-up coeliac children: the effects of only a few years on a gluten-free diet in childhood
C. Ciacci et al
AIM: To evaluate clinical and psychological status of adults with childhood diagnosis of coeliac disease who were re-exposed to gluten after only a few years and now on a gluten-containing diet, compared with adults with recent diagnosis of coeliac disease, and adults who remained on gluten-free diet after childhood diagnosis.
METHODS: A total of 195 adults with a biopsy suggestive of coeliac disease in childhood, who either had adhered to a gluten-free diet for at least 1 year after diagnosis and now are either on gluten-free diet (n = 110) or on gluten-containing diet (n = 85), and adults with newly diagnosed coeliac disease (n = 165) underwent a medical check-up.
RESULTS: Body mass index and main laboratory indices were statistically different among groups (lowest in never on gluten-free diet, highest in gluten-free diet). The lowest average levels of bone mineral density were found among never on gluten-free diet patients. Prevalence of autoimmune disorders was increased in never on gluten-free diet when compared with the transient gluten-free diet and gluten-free diet groups. Histology revealed villous subatrophy in all patients of never on gluten-free diet group, in 39 of 110 patients of gluten-free diet and in 84 of 85 of transient gluten-free diet groups. Herpetiform dermatitis was found in three patients of gluten-free diet, three of transient gluten-free diet and three of never on gluten-free diet. Dental enamel defects were found in 15 patients of transient gluten-free diet, 43 of never on gluten-free diet and in zero of the gluten-free diet group. Pregnancy outcome was not significantly different between the two groups, but neonatal weight was lower and breast feeding was shorter in the never on gluten-free diet group. Sexual habits, alcohol intake and cigarette smoking were significantly different in the never on gluten-free diet group when compared with the other two groups.
CONCLUSION: Gluten withdrawal in childhood partly protects coeliac adults from clinical and behavioural effects of gluten sensitivity.
www.ncbi.nlm.nih.gov/pubmed/15709993?dopt=Abstract
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Celiac disease and the transition from childhood to adulthood: a 28-year follow-up.
O'Leary C, Wieneke P, Healy M, Cronin C, O'Regan P, Shanahan F.
Alimentary Pharmabiotic Centre and Department of Medicine, National University of Ireland, Cork and Affiliated Teaching Hospitals, Cork, Ireland.
OBJECTIVES: Follow-up of celiac disease diagnosed in childhood is variable or nonexistent after transition to adulthood. Outcome, continuity of care, and adherence to a gluten-free diet are poorly documented. We report a 28-yr follow-up of 50 adults in whom the original childhood diagnosis could be confirmed.
METHODS: Original pediatric charts were reviewed, and subjects were invited to undergo dietary evaluation, measurement of bone mineral density, and quality-of-life assessment. The mean duration of celiac was 28.5 yr, median 28.7 yr (range 22-45 yr). The mean and median age of the group was 35 yr.
RESULTS: Only 22% of patients were enrolled in an adult gastroenterology clinic. Fifty percent were fully compliant with a gluten-free diet; 18% were partially compliant; and 32% were not adhering to diet. The main motivating factor for dietary compliance was avoidance of symptoms rather than avoidance of complications. Eighty-six percent of the females and 21% of the males had iron deficiency. Bone mineral density was subnormal in 32%; 28.9% were osteopenic and 2.6% were osteoporotic. Quality-of-life scores were normal.
CONCLUSIONS: Most patients diagnosed with celiac in childhood receive no medical or dietary supervision after transition to adulthood.
One-third are not compliant with diet; the primary motivating factor for those who do comply is avoidance of symptoms rather than fear of complications.
he prevalence of preventable and treatable disorders in these young adults highlights a failure of health services after transition from pediatric to adult health care.
www.ncbi.nlm.nih.gov/pubmed/15571593?dopt=AbstractPlus
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Long-term follow-up of 61 celiac patients diagnosed in childhood: evolution toward latency is possible on a normal diet
Posted by Jackie MOT on 26/2/2007
GF board
Long-term follow-up of 61 celiac patients diagnosed in childhood: evolution toward latency is possible on a normal diet.
Matysiak-Budnik T, Malamut G, Patey-Mariaud de Serre N, Grosdidier E, Seguier S, Brousse N, Caillat-Zucman S, Cerf-Bensussan N, Schmitz J, Cellier C.
INSERM U793, Faculte de Medecine Rene Descartes, France.
Background & aims: Whether a life-long gluten free diet (GFD) is necessary in asymptomatic children with celiac disease (CD) remains debated. To address this question, we have retrospectively analyzed clinical and biological status of adult celiac patients diagnosed in childhood, who remained on a normal diet after gluten challenge and were clinically silent.
METHODS: Patients aged 18-65 years with CD diagnosed in childhood were included. Clinical status, gluten intake, biological parameters of malabsorption, bone mineral density, HLA genotype, serological markers of CD, and histological and immuno-histochemical parameters in duodenal biopsies were recorded.
RESULTS: Sixty one patients had resumed a normal diet and were asymptomatic. Forty eight showed different degrees of villous atrophy (silent CD), while 13 had no detectable atrophy (latent CD) on duodenal biopsies. Latent CD patients had significantly less osteopenia/osteoporosis [1/9 (11%) versus 23/33 (70%), p<0.001)], and lower TcR-alphabeta+ intraepithelial T cell counts (38+/-20 vs 55+/-15, p<0.01) than silent CD patients. The mean age at diagnosis and first GFD was lower in latent than in silent patients (14.4+/-5 vs 40.1+/-47 months, p<0.05). Latent patients did not differ significantly from the seven control patients on a long-term GFD, except for a higher frequency of CD-specific serum antibodies. However, two latent patients relapsed clinically and histologically during subsequent follow up.
CONCLUSIONS: Long-term latency developed in about 20% of CD patients who remained symptom free after gluten reintroduction.
This latency can be transient and thus a regular follow-up is mandatory.
In silent patients, the increased risk of osteoporosis substantiates the need of GFD.
**********
Grown-up coeliac children: the effects of only a few years on a gluten-free diet in childhood
C. Ciacci et al
AIM: To evaluate clinical and psychological status of adults with childhood diagnosis of coeliac disease who were re-exposed to gluten after only a few years and now on a gluten-containing diet, compared with adults with recent diagnosis of coeliac disease, and adults who remained on gluten-free diet after childhood diagnosis.
METHODS: A total of 195 adults with a biopsy suggestive of coeliac disease in childhood, who either had adhered to a gluten-free diet for at least 1 year after diagnosis and now are either on gluten-free diet (n = 110) or on gluten-containing diet (n = 85), and adults with newly diagnosed coeliac disease (n = 165) underwent a medical check-up.
RESULTS: Body mass index and main laboratory indices were statistically different among groups (lowest in never on gluten-free diet, highest in gluten-free diet). The lowest average levels of bone mineral density were found among never on gluten-free diet patients. Prevalence of autoimmune disorders was increased in never on gluten-free diet when compared with the transient gluten-free diet and gluten-free diet groups. Histology revealed villous subatrophy in all patients of never on gluten-free diet group, in 39 of 110 patients of gluten-free diet and in 84 of 85 of transient gluten-free diet groups. Herpetiform dermatitis was found in three patients of gluten-free diet, three of transient gluten-free diet and three of never on gluten-free diet. Dental enamel defects were found in 15 patients of transient gluten-free diet, 43 of never on gluten-free diet and in zero of the gluten-free diet group. Pregnancy outcome was not significantly different between the two groups, but neonatal weight was lower and breast feeding was shorter in the never on gluten-free diet group. Sexual habits, alcohol intake and cigarette smoking were significantly different in the never on gluten-free diet group when compared with the other two groups.
CONCLUSION: Gluten withdrawal in childhood partly protects coeliac adults from clinical and behavioural effects of gluten sensitivity.
www.ncbi.nlm.nih.gov/pubmed/15709993?dopt=Abstract
*****************
Celiac disease and the transition from childhood to adulthood: a 28-year follow-up.
O'Leary C, Wieneke P, Healy M, Cronin C, O'Regan P, Shanahan F.
Alimentary Pharmabiotic Centre and Department of Medicine, National University of Ireland, Cork and Affiliated Teaching Hospitals, Cork, Ireland.
OBJECTIVES: Follow-up of celiac disease diagnosed in childhood is variable or nonexistent after transition to adulthood. Outcome, continuity of care, and adherence to a gluten-free diet are poorly documented. We report a 28-yr follow-up of 50 adults in whom the original childhood diagnosis could be confirmed.
METHODS: Original pediatric charts were reviewed, and subjects were invited to undergo dietary evaluation, measurement of bone mineral density, and quality-of-life assessment. The mean duration of celiac was 28.5 yr, median 28.7 yr (range 22-45 yr). The mean and median age of the group was 35 yr.
RESULTS: Only 22% of patients were enrolled in an adult gastroenterology clinic. Fifty percent were fully compliant with a gluten-free diet; 18% were partially compliant; and 32% were not adhering to diet. The main motivating factor for dietary compliance was avoidance of symptoms rather than avoidance of complications. Eighty-six percent of the females and 21% of the males had iron deficiency. Bone mineral density was subnormal in 32%; 28.9% were osteopenic and 2.6% were osteoporotic. Quality-of-life scores were normal.
CONCLUSIONS: Most patients diagnosed with celiac in childhood receive no medical or dietary supervision after transition to adulthood.
One-third are not compliant with diet; the primary motivating factor for those who do comply is avoidance of symptoms rather than fear of complications.
he prevalence of preventable and treatable disorders in these young adults highlights a failure of health services after transition from pediatric to adult health care.
www.ncbi.nlm.nih.gov/pubmed/15571593?dopt=AbstractPlus
**************
Long-term follow-up of 61 celiac patients diagnosed in childhood: evolution toward latency is possible on a normal diet
Posted by Jackie MOT on 26/2/2007
GF board
Long-term follow-up of 61 celiac patients diagnosed in childhood: evolution toward latency is possible on a normal diet.
Matysiak-Budnik T, Malamut G, Patey-Mariaud de Serre N, Grosdidier E, Seguier S, Brousse N, Caillat-Zucman S, Cerf-Bensussan N, Schmitz J, Cellier C.
INSERM U793, Faculte de Medecine Rene Descartes, France.
Background & aims: Whether a life-long gluten free diet (GFD) is necessary in asymptomatic children with celiac disease (CD) remains debated. To address this question, we have retrospectively analyzed clinical and biological status of adult celiac patients diagnosed in childhood, who remained on a normal diet after gluten challenge and were clinically silent.
METHODS: Patients aged 18-65 years with CD diagnosed in childhood were included. Clinical status, gluten intake, biological parameters of malabsorption, bone mineral density, HLA genotype, serological markers of CD, and histological and immuno-histochemical parameters in duodenal biopsies were recorded.
RESULTS: Sixty one patients had resumed a normal diet and were asymptomatic. Forty eight showed different degrees of villous atrophy (silent CD), while 13 had no detectable atrophy (latent CD) on duodenal biopsies. Latent CD patients had significantly less osteopenia/osteoporosis [1/9 (11%) versus 23/33 (70%), p<0.001)], and lower TcR-alphabeta+ intraepithelial T cell counts (38+/-20 vs 55+/-15, p<0.01) than silent CD patients. The mean age at diagnosis and first GFD was lower in latent than in silent patients (14.4+/-5 vs 40.1+/-47 months, p<0.05). Latent patients did not differ significantly from the seven control patients on a long-term GFD, except for a higher frequency of CD-specific serum antibodies. However, two latent patients relapsed clinically and histologically during subsequent follow up.
CONCLUSIONS: Long-term latency developed in about 20% of CD patients who remained symptom free after gluten reintroduction.
This latency can be transient and thus a regular follow-up is mandatory.
In silent patients, the increased risk of osteoporosis substantiates the need of GFD.
**********