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A lady with abdominal cramps
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
The clinical features of coeliac disease cover a wide spectrum from profuse diarrhoea with malabsorption and weight loss, to more vague symptoms such as bloating and cramping abdominal pain. Blood for serological markers of this disease (transglutaminase antibody, endomysial antibody, IgA) should be obtained. Biopsies from the distal duodenum taken during OGD are needed to give a definite diagnosis (see p. 201).
Disorders of the digestive tract
Published in Judy Bothamley, Maureen Boyle, Medical Conditions Affecting Pregnancy and Childbirth, 2020
Coeliac disease was once thought to be diagnosed mainly in childhood but the median age of diagnosis is 44 years25, and therefore some women who are pregnant may have undiagnosed coeliac disease. Unexplained anaemia is a common presentation for undiagnosed coeliac. Bone pain from osteoporosis, due to malabsorption of calcium and vitamin D, may also occur23. Coeliac disease may be associated with an increased risk of infertility, miscarriage, fetal growth restriction, low birth weight and preterm delivery, although these risks are reduced significantly when the woman is able to maintain a strict gluten-free diet26.
Nutrition for Special Needs—In Pediatric Gastrointestinal Diseases
Published in Fima Lifshitz, Childhood Nutrition, 2020
Particularly for celiac disease, a gluten-free diet (avoidance of all wheat, rye and barley) is important. Extra fat-soluble vitamins are necessary, and iron-and/or Mate-deficient patients need appropriate supplements.
Risk of vascular diseases in patients with dermatitis herpetiformis and coeliac disease: a long-term cohort study
Published in Annals of Medicine, 2023
Noora Nilsson, Joonas Leivo, Pekka Collin, Inka Koskinen, Katri Kaukinen, Heini Huhtala, Johanna Palmio, Timo Reunala, Kaisa Hervonen, Teea Salmi, Camilla Pasternack
Coeliac disease is a common immune-mediated intestinal disorder driven by dietary gluten in genetically predisposed individuals [1]. Gastrointestinal symptoms, such as diarrhoea and abdominal pain, are considered to be the classic symptoms of coeliac disease, but the disease may also present with a variety of extraintestinal symptoms [1]. Dermatitis herpetiformis (DH), a cutaneous manifestation of coeliac disease, typically presents as a pruritic, blistering, and papular rash [2]. In DH patients, granular immunoglobulin A (IgA) deposits are seen in the papillary dermis and epidermal transglutaminase (TG3) acts as the target autoantigen [3]. In addition, patients with DH also have a coeliac-type systemic disease with circulating antibodies against tissue transglutaminase (TG2) and a varying degree of enteropathy, ranging from minor inflammatory changes to severe villous atrophy in the small bowel mucosa [2]. Regardless of the intestinal findings, DH patients rarely have severe gastrointestinal symptoms [2].
Methotrexate induced peritonitis: diagnosis per exclusionem
Published in Journal of Obstetrics and Gynaecology, 2021
Raphaël Rienstra, Eva A.S. Koster, Catharina C.A.H. Janssen
Gastritis (Helicobacter pylori).Gastric ulcer.Stomach perforation.Cholecystitis.Pancreatitis.Pulmonary embolism.Peritonitis.Pericarditis.Molar metastasis.Coeliac disease.
Well-being and dietary adherence in patients with coeliac disease depending on follow-up
Published in Scandinavian Journal of Gastroenterology, 2021
Jesper Lexner, Henrik Hjortswang, Rickard Ekesbo, Klas Sjöberg
If undiagnosed or not properly treated coeliac disease may cause both physical and psychological complications. Some of those are related to malabsorption, such as iron or vitamin deficiencies [6]. As for psychiatric comorbidities, quality of life can be impaired and there is an increased risk of depression [7,8]. Particularly women suffer from a reduced level of well-being, and those with more gastrointestinal symptoms usually have lower levels of well-being [9]. Quality of life, and maybe also depressive symptoms, tend to improve when a strict gluten-free diet is initiated [7,8]. Fatigue is another common extraintestinal symptom [10]. Due to its autoimmune nature and relation to HLA-DQ2 and -DQ8, patients with coeliac disease have an increased risk of other autoimmune diseases, such as type 1 diabetes mellitus and autoimmune thyroid diseases [11]. These examples illustrate the importance of not just an early diagnosis, but also a qualified and thorough follow-up care afterwards both to ensure compliance to the gluten-free diet and to discover complications.