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1.
[Mesenteric lymph node cavitation in celiac disease: Report of four cases and literature review].
Ruch, Y, Labidi, A, Martin, A, Weingertner, N, Hansmann, Y, Lefebvre, N, Andres, E, Argemi, X, Dieudonné, Y
La Revue de medecine interne. 2019;(8):536-544
Abstract
INTRODUCTION Mesenteric lymph node cavitation is an exceptional complication of celiac disease. We report four original observations of this syndrome, completed by a literature review. DISCUSSION The analysis of 38 cases showed that this complication occurred exclusively in adults, with a mean age at diagnosis of 54 years. It revealed the celiac disease in the majority of cases. Hyposplenism was almost systematically associated. The risk of lymphoma appeared higher, especially enteropathy-associated T-cell lymphoma. The prognosis was poor with nearly 50% mortality and seemed related to the clinical response to the gluten-free diet. CONCLUSION The severity of this complication deserves to be known and should lead to its research in celiac patients, especially in cases diagnosed in adulthood or in case of refractory disease.
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2.
Hemorrhagic Events in Adult Celiac Disease Patients. Case Report and Review of the Literature.
Dima, A, Jurcut, C, Manolache, A, Balaban, DV, Popp, A, Jinga, M
Journal of gastrointestinal and liver diseases : JGLD. 2018;(1):93-99
Abstract
BACKGROUND AND AIMS Celiac disease (CD) presents with a wide spectrum of extra-digestive symptoms, including hemorrhagic manifestations. The aim of this review was to conduct an extensive analysis of the hemorrhagic events reported in adult CD patients. METHODS Case report and review of the literature. Pubmed (MEDLINE) database search from January 1970 onwards was performed using the medical subject headings [MeSH] terms "celiac disease" AND "blood coagulation disorders", "hemorrhage", "hematoma", "hematuria", "hemoptysis", "epistaxis", "hemosiderosis". Only case reports were identified on the search theme. Information on patients' characteristics, diagnostic features, coagulation parameters, symptomatology duration, and evolution under treatment were systematically collected and summarized. RESULTS We present the case of a 40-year-old man hospitalized for spontaneous muscular hematomas, in whom CD was diagnosed. We performed a review of the literature and summarized the published case reports of 46 CD patients, aged between 19 and 74 years, 64% of male gender. In 25% of cases, the symptomatology was present for more than 5 years prior to CD diagnosis. The clinical hemorrhagic events were as follows: 15 patients had gastrointestinal bleeding, 9 hemoptysis, 4 epistaxis, 6 hematuria, 8 cutaneous hematoma, petechia or ecchymoses, and only in 1 case hemarthrosis, hemorrhagic vesicular dermatitis, subcortical hemorrhage, or adrenal hemorrhage. Sixty percent of the patients had digestive symptoms, while the rest had only extra-digestive CD involvement. The Lane Hamilton syndrome was defined in 15 patients. The evolution under a gluten-free diet was favorable in most cases. CONCLUSION This review of case reports aims to increase awareness to hemorrhagic events, rare but possible life-threatening conditions, as part of the CD clinical spectrum. To the best of our knowledge, this is the first review of all types of hemorrhagic events in adult CD patients.
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A Challenging Diagnosis of Jejunal Adenocarcinoma in a Celiac Patient: Case Report and Systematic Review of the Literature.
Zullo, A, De Francesco, V, Manta, R, Ridola, L, Lorenzetti, R
Journal of gastrointestinal and liver diseases : JGLD. 2017;(4):411-415
Abstract
Celiac disease (CD) is a common and chronic disorder requiring a long-life gluten-free diet. There is evidence that asymptomatic or subclinical presentation of CD has increased in the last decades, so that several cases are diagnosed during adulthood or even in the elderly. Celiac disease patients are at an increased risk of developing malignancies, particularly when the disease is diagnosed in the elderly. We describe a case of a challenging diagnosis of small bowel adenocarcinoma which developed in a patient with CD discovered only in the elderly. We also performed a systematic review of the literature. A tailored follow-up in a sub-group of CD patients at an increased risk of developing intestinal adenocarcinoma could be implemented.
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Gluten-Free hepatomiracle in "celiac hepatitis": A case highlighting the rare occurrence of nutrition-induced near total reversal of advanced steatohepatitis and cirrhosis.
Gaur, K, Sakhuja, P, Puri, AS, Majumdar, K
Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association. 2016;(6):461-464
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Abstract
Regression of hepatic fibrosis is increasingly becoming a reality, both in clinical as well as experimental models. Reversal or near-total regression of marked liver steatohepatitis and fibrosis, however, remains a rare event. We report the case of a 20-year-old female presenting with diarrhea due to celiac disease and biopsy proven cirrhosis with portal hypertension who had a remarkable clinical improvement in response to a gluten free diet (GFD). A follow-up liver biopsy 9 months after the initiation of GFD revealed a remarkable regression of both fibrosis as well as steatosis. Villous atrophy, as seen in patients with celiac disease, could lead to a deprivation of trophic factors leading to liver injury and subsequent cirrhosis. A gluten-free dietary regimen can produce a reversal of fibrosis leading to the amelioration of symptoms associated even with advanced liver disease.
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Coeliac disease not responding to a gluten-free diet in children: case studies and literature review.
Janczyk, W, de Roo, JH, Schweizer, J, Socha, J, Socha, P, Mearin, ML
Developmental period medicine. 2015;(2):162-6
Abstract
We presented the cases of three children with coeliac disease who despite good adherence to a glutenfree diet remained non-responsive to treatment. Two patients, one of them with IgA deficiency, were successfully treated by complete gluten exclusion with enteral nutrition. However the third child with a severe coeliac disease did not achieve clinical and histologic improvement, even on immunosuppressive treatment. If no hidden sources of gluten can be identified, other causes of persistent villous atrophy, dierent from coeliac disease, have to be considered. They include e.g. inflammatory, immune and endocrine diseases of the digestive tract. In severe cases of childhood coeliac disease not responding to a gluten free diet, autoimmune enteropathy and refractory coeliac disease must be taken into account.
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[Celiac disease with epilepsy and minor neurological disorders].
Tirotta, D, Eusebi, G, Durante, V
Recenti progressi in medicina. 2012;(5):198-204
Abstract
We present the case of a woman with abdominal pain, headache, syncope. The diagnosis of celiac disease (CD), associated with epilepsy and the brief review of literature, suggest that CD should be considered in neurological disorders of unknown etiology. The diet can be effective only on abdominal pain.
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[Celiac disease associated with Budd-Chiari syndrome].
Ouakaa-Kchaou, A, Ennaifer, R, Belhadj, N, Gargouri, D, Elloumi, H, Romani, M, Kochlef, A, Kilani, A, Kharrat, J, Ghorbel, A
Presse medicale (Paris, France : 1983). 2008;(2 Pt 1):239-41
Abstract
INTRODUCTION Budd-Chiari syndrome is a rare disease defined by obstruction of the hepatic portal vein. Its association with celiac disease is rare. CASE We report the case of a 28-year-old woman who presented with celiac disease associated with Budd-Chiari syndrome for which no cause could be found. A gluten-free diet and antivitamin K treatment led to a favorable outcome. DISCUSSION This case and a review of the literature suggest that the pathogenesis of these two disorders is linked.
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Oral manifestations of celiac disease. A case report and review of the literature.
da Silva, PC, de Almeida, Pdel V, Machado, MA, de Lima, AA, Grégio, AM, Trevilatto, PC, Azevedo-Alanis, LR
Medicina oral, patologia oral y cirugia bucal. 2008;(9):E559-62
Abstract
Celiac disease is a chronic intestinal disease caused by intolerance to gluten associated with poor digestion and absorption of the majority of nutrients and vitamins, which may affect both developing dentition and oral mucosa. The aim of this study is to make a brief review of the literature about celiac disease and to report on a clinical case, showing the impact it may have on the general and oral health. A 39-year-old woman reported the presence of diarrhea, nauseas, flatulence, colic, difficulty with falling asleep, lack of appetite and loose of 18 Kg in the last two years. She also noted the appearance of symptomatic lesions in the mouth. These lesions had a mean duration of a month and occurred in any region of the oral mucosa, particularly on the tongue. Multiples ulcerations were found in the sublingual caruncula region, at the vestibular fornix and at the lingual apex. Topical treatment was instituted for the oral lesions with immediately relief of the symptoms. The diagnosis of celiac disease was established by means of medical clinical exam, biopsy of the small intestine, and by the presence of specific antibodies in the blood. The patient has been instructed to follow a gluten-free diet. Multiprofessional action with the involvement of a gastroenterologist and other health professionals, such as dentists, is important for diagnosing the disease and guiding the patient with celiac disease to achieve a good quality of life.
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Women and celiac disease: association with unexplained infertility.
Pellicano, R, Astegiano, M, Bruno, M, Fagoonee, S, Rizzetto, M
Minerva medica. 2007;(3):217-9
Abstract
Celiac disease (CD) is a permanent intolerance to gluten characterized by destructions of the small intestinal villi and malabsorption. The gluten-free diet (GFD) results in healing of the mucosa, resolution of the malabsorpitive states, and reversal of great part of CD effects. Among the extradigestive complications associated with CD, unexplained infertility has been reported since the 70's. The prevalence of CD among women with unexplained infertility is 2.5-3.5%, higher, although not always significantly, than control population. To date, it is widely accepted that untreated CD represents a risk for abortion, low birth weight babies and short-breast feeding period. These features can be corrected by GFD. Some discrepancies could stem from the heterogeneity of the studies. Regarding a potential pathogenic mechanism, since CD causes malabsorption of folic acid and other nutrients, this pathway has been proposed to explain the unfavourable outcomes of pregnancy. However, this remains a speculation. In conclusion, each woman with unexplained infertility should be screened for CD.
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Refractory coeliac disease: remission with infliximab and immunomodulators.
Turner, SM, Moorghen, M, Probert, CS
European journal of gastroenterology & hepatology. 2005;(6):667-9
Abstract
Coeliac disease is a T-cell-mediated enteropathy induced by gluten. A minority of patients who fail to respond to a gluten-free diet may require intervention with immunomodulating drugs. We report a case of refractory coeliac disease where remission was induced by the anti-tumour necrosis factor-alpha antibody infliximab and was maintained with prednisolone and azathioprine.