rome and Celiac-Disease

Functional abdominal pain disorders (FAPDs) are among the most common causes of consultation in general pediatrics and pediatric gastroenterology. The Rome IV criteria recommend testing for celiac disease (CD) in children with irritable bowel syndrome-diarrhea (IBS-D) and leaves testing in cases of other FAPDs to the practitioner's discretion. These recommendations were based on a single study that showed a 4-fold increase of CD among patients with IBS in Italy. It is unclear if these findings can be extrapolated to other populations. Understanding whether those results are reproducible in areas with different racial/ethnic backgrounds can optimize patient care.. The aim of the study was to assess the prevalence of CD in a sample of children consulting for FAPDs to a tertiary care center in Miami.. The charts of all pediatric patients consulting for FAPDs from January 2016 to November 2019 at the University of Miami were reviewed. Demographics, diagnosis, and CD testing for each child were analyzed.. One hundred eighty-one children with FAPDs and celiac testing were seen. Mean age of 12.89 years, girls 61.34%. 84 (46.40%) had a diagnosis of IBS and 97 (53.59%) had a diagnosis of other FAPD. One of 181 children with FAPDs (0/84 with IBS and 1/97 with other FAPDs) had positive CD serological testing and EGD confirmation.. Our study suggests that the prevalence of CD among children with FAPDs is similar to the community prevalence. This data questions the benefit of testing all children FAPDS (including IBS) for CD. Studies with larger sample size and various racial/ethnic makeup should be done to confirm our findings.

Topics: Abdominal Pain; Celiac Disease; Child; Female; Hispanic or Latino; Humans; Irritable Bowel Syndrome; Italy; Prevalence; Rome

Coeliac disease (CD) is a chronic, gluten-dependent enteropathy with a prevalence of approximately 1% in Western countries. Up to now, CD has been described only in sporadic cases of obesity. Our study aimed to evaluate retrospectively CD prevalence in a large series of overweight/obese children and adolescents. Among the 1527 overweight/obese children and adolescents consecutively evaluated, 17 (7 boys, 1.11%) were positive for serology and showed villous atrophy. In all of the patients with CD a well-balanced gluten-free diet was started, and a loss of weight rapidly obtained. Our study demonstrates that CD prevalence in overweight/obese children is similar to the general paediatric population in Italy.

Topics: Adolescent; Adolescent Development; Adult; Body Mass Index; Celiac Disease; Child; Child Development; Child Nutritional Physiological Phenomena; Child, Preschool; Cohort Studies; Diet, Gluten-Free; Female; Follow-Up Studies; Humans; Male; Mass Screening; Obesity; Overweight; Pediatric Obesity; Prevalence; Retrospective Studies; Rome; Weight Loss; Young Adult

The aim of this study was to investigate if co-morbid conditions as hepatitis C virus infection and celiac disease may be associated to undifferentiated connective tissue disease.. We studied retrospectively and prospectively 52 patients with diagnosis of undifferentiated connective tissue disease, subdivided, according to Vaz criteria, in systemic lupus erythematosus, systemic sclerosis and Sjögren's syndrome-like subgroups. Serological markers of celiac disease as anti-gliadin, anti-endomysium and anti-tissue transglutaminase antibodies were investigated. An esophagogastroduodenoscopy with duodenal biopsy and histological examination was proposed to patients with positive celiac disease serology. In addition antibodies directed to hepatitis C virus and total IgA-antibodies were investigated.. Six patients (11,5%) were positive for celiac disease serological tests although two of them were asymptomatic. Four patients underwent an esophagogastroduodenoscopy, showing total or subtotal villous atrophy at duodenal biopsies. Hepatitis C virus serology was negative in all patients and none had IgA deficiency. 83% of celiac patients showed a scleroderma-like phenotype. We observed a statistically higher incidence of autoimmune symptoms in patients with gluten sensitivity. Fatigue and myalgia regressed early after the beginning of gluten-free diet.. In our cohort of patients the prevalence of celiac disease was higher than that reported in the general population. We believe that all patients with diagnosis of undifferentiated connective tissue disease, especially those with a systemic sclerosis-like presentation, should be investigated for celiac disease, even in absence of gastrointestinal symptoms. Gluten-free diet should be early recommended to all patients having undifferentiated connective tissue disease and gluten sensitivity.

Topics: Adult; Aged; Autoantibodies; Biomarkers; Biopsy; Celiac Disease; Comorbidity; Connective Tissue Diseases; Diet, Gluten-Free; Duodenum; Endoscopy, Gastrointestinal; Female; Hepatitis C; Humans; Lupus Erythematosus, Systemic; Male; Middle Aged; Predictive Value of Tests; Prevalence; Prospective Studies; Retrospective Studies; Risk Factors; Rome; Scleroderma, Systemic; Serologic Tests; Sjogren's Syndrome; Young Adult

The etiopathogenesis of psoriasis is still unclear. Associations between gut and skin diseases are well known, since psoriatic patients show a high prevalence of coeliac disease. Small-bowel abnormalities can cause clinical or, more frequently, laboratory alterations that give rise to malabsorption. The aim of the study was to evaluate the prevalence of malabsorption in psoriatic patients.. Fifty-five (29 M, 26 F, mean age 51+/-8 years) psoriatic patients in the Dermatology Centre of our hospital and 65 healthy controls (36 M, 29 F, mean age 47+/-9 years) were screened for malabsorption using a D-xylose test. Psoriatic subjects who resulted positive were further investigated in order to reach a better characterization of the malabsorption using serum antigliadin, anti-endomysium and anti-transglutaminase antibodies, H2 lactulose breath test, the parasitological faecal test and colonoscopy with retrograde ileoscopy.. Altered D-xylose absorption was found in 60% (33/55) of psoriatic patients and in 3% (2/65) of controls. Of the former, 6% had coeliac disease, 21% had bacterial overgrowth, 3% had parasitic infections and 1 patient presented eosinophilic gastroenteritis.. Malabsorption was more prevalent among psoriatic patients than among controls. Coeliac disease, bacterial overgrowth, parasitic infestations and eosinophilic gastroenteritis could be possible causes of malabsorption in these patients. Further studies are needed to clarify the pathogenesis and possible causative associations between gut and skin diseases.

Topics: Adult; Case-Control Studies; Celiac Disease; Female; Gastritis; Humans; Intestinal Diseases, Parasitic; Malabsorption Syndromes; Male; Middle Aged; Prevalence; Psoriasis; Rome; Xylose