Diagnosis of Cavitating Mesenteric Lymph Node Syndrome in Celiac Disease Using MRI. Huppert B, Farrell M, Kawashima A, Murray J. Coeliac Disease, Epilepsy and Cerebral Calcifications. Down's Syndrome is Strongly Associated with Coeliac Disease. Gale L, Wimalaratna H, Brotodiharjo A, Duggan J. Malignant Lymphomas in Coeliac Disease: Evidence of Increased Risks for Lymphoma Types Other Than Enteropathy-Type T Cell Lymphoma. Smedby K, Akerman M, Hildebrand H, Glimelius B, Ekbom A, Askling J. Robbins and Cotran Pathologic Basis of Disease.
Antigliadin and Antiendomysium Antibody Determination for Coeliac Disease. Bürgin-Wolff A, Gaze H, Hadziselimovic F et al. CT Enteroclysis Features of Uncomplicated Celiac Disease: Retrospective Analysis of 44 Patients. Celiac Disease: How Common is Jejunoileal Fold Pattern Reversal Found at Small-Bowel Follow-Through? AJR Am J Roentgenol. Radiographic Indicants of Adult Celiac Disease Assessed by Double-Contrast Small Bowel Enteroclysis. La Seta F, Salerno G, Buccellato A, Tinè F, Furnari G. Idiopathic Steatorrhoea and Idiopathic Pulmonary Haemosiderosis. Enteroclysis in Adult Celiac Disease: Diagnostic Value of Specific Radiographic Features. Lomoschitz F, Schima W, Schober E, Turetschek K, Kaider A, Vogelsang H. Mesenteric Lymph Node Cavitation in Celiac Disease. Celiac Disease in Adults: Evaluation with MDCT Enteroclysis. Increased risk of development of carcinoma of the esophagus Increased risk of malignant conditions such as small bowel lymphoma (mainly T-cell type) and small bowel adenocarcinoma Submucosal fat deposition in long-standing casesĪ strict lifelong gluten-free diet is the mainstay of treatment of this condition and is effective in the vast majority of patients.Ī small subset of patients do not respond despite fastidious gluten-free nutrition, representing refractory celiac disease 15. Prominent mesenteric lymph nodes may cavitate with a fluid-fat level Jejunoileal fold pattern reversal: thought to have the highest specificity is considered the most discriminating independent variable for the diagnosis of uncomplicated celiac disease
Multiple non-obstructing intussusceptions ( coiled spring appearance)įeatures present on CT enteroclysis and MR enterography may include 3,6,18-20: Small intestinal dilatation due to excess fluid Quantitative immunoglobulin A (IgA): measures the total level of IgA in the blood to determine if someone is deficient in the IgA class of antibodies. The IgG class of anti-tTG may be assayed for people who have a deficiency of IgA.įeatures of small bowel barium studies are not sensitive enough for confident diagnosis, but the following changes may be seen: Total villous loss, initially blunting, progressing to flattened mucosaĮpithelial infiltration with T-cell lymphocytesĪdditionally, serum antibodies may be raised:Īntitissue transglutaminase antibody (anti-tTG), IgAĭeamidated gliadin peptide (DGP) antibodies, IgAĪntiendomysial antibodies (EMA), IgA classĪntireticulin antibodies (ARA), IgA class The gold standard diagnostic test is a duodenal biopsy taken at endoscopy. The villous atrophy that occurs within the bowel also results in malabsorption of iron, folic acid, calcium and fat-soluble vitamins manifesting in a variety of signs, some of which may be non-specific. There is loss of villi, which absorb fluid, and hypertrophy of crypts, which produce fluid, resulting in excess fluid in the small bowel lumen 8. The disease tends to start in the duodenum and extends into the ileum, resulting in induction crypt hyperplasia. Small bowel mucosa is primarily affected (submucosa, muscularis and serosa remain unaffected), resulting in progressive degrees of villous inflammation and destruction. Rickets (rare when celiac disease is recognized and treated)Ĭeliac disease is a chronic autoimmune disease induced in genetically susceptible individuals after ingestion of gluten. Musculoskeletal manifestations of celiac disease Usually mild but rarely can lead to liver failure Hepatobiliary manifestations of celiac disease Hematological manifestations of celiac diseaseĪnemia (common in poorly treated individuals) These include 16,17:Ĭentral nervous system manifestations of celiac diseaseĮndocrinological manifestations of celiac diseaseĪutoimmune thyroid disease is more common in individuals with celiac disease In addition to gastrointestinal manifestations, some individuals may have other systemic manifestations, sometimes without evidence of enteropathy. Malabsorption, including fat-soluble vitamins Iron-deficiency anemia and guaiac-positive stoolsĪbnormal bowel habit (e.g. However, abdominal pain is considered the most common symptom. Many patients have a paucity of symptoms with no gastrointestinal upset.
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