By Alessio Fasano, Dr. Alessio Fasano MD
A scientific advisor to Gluten-Related issues presents basic healthiness care services the succinct fabric they should instantly assessment and help their sufferers. Gluten-related issues have a large presentation, and this article covers the popularity, review, and multi-disciplinary method of the administration of sickness. Readers will enjoy the basic assessment of gluten intolerance and from the common experience method of constructing remedy and nutritional plans. scientific vignettes supply clinicians real-life eventualities to assist placed the disorder and its therapy in context for his or her patients. �Read more...
summary: A medical consultant to Gluten-Related problems presents basic healthiness care services the succinct fabric they should instantly evaluation and help their sufferers. Gluten-related problems have a large presentation, and this article covers the popularity, overview, and multi-disciplinary method of the administration of sickness. Readers will enjoy the basic review of gluten intolerance and from the common-sense method of constructing therapy and nutritional plans. medical vignettes provide clinicians real-life situations to aid placed the ailment and its remedy in context for his or her sufferers
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Additional info for A Clinical Guide to Gluten-Related Disorders
They could investigate four of such patients in detail, and in all of them the diagnosis of CD was eventually excluded. In fact, in some, after prolonged gluten challenge, the small intestinal pathology remained completely normal, while in others a revision of the original pathology described Crohn disease or common variable immunodeficiency. 5, or HLA-DQ8. These data support the use of HLA testing for its high negative predictive value, meaning CD can be ruled out in those lacking HLA-DQ2 or HLA-DQ8 (Fig.
Their celiac serologies may be positive or negative. Two variants have been described on the basis of the timing of villous blunting. In the first form, CD is diagnosed, the patient is put on a GFD, and the mucosa recovers completely. The patient then maintains normal duodenal architecture upon reintroduction of gluten. 130 However, the majority of the celiac patients with clinical tolerance to gluten had evidence of villous atrophy and increased risk of osteopenia and osteoporosis. In addition, the latency can be transient necessitating regular follow-up.
135 Other hematologic manifestations of CD include thrombocytosis that may be due to iron deficiency or hyposplenism, IgA deficiency, and rarely intestinal T cell lymphomas. Coagulopathy may occur secondary to vitamin K malabsorption, but this is rare. Leukopenia and neutropenia may occur secondary to folate, copper, or vitamin B12 deficiencies versus autoimmune processes. 132 Growth and Development: Short Stature, Delayed Puberty Short stature may be the second most common extraintestinal manifestation of CD behind iron deficiency anemia.
A Clinical Guide to Gluten-Related Disorders by Alessio Fasano, Dr. Alessio Fasano MD