Celiac syndrome

C8. Collins-Williams, C., and Ebbs, J. H., Use of protein skin tests in celiac syndrome. Ann. Allergy 12, 237-240 (1954). 

D7. Douglas, A. P., Crabbe, P. A., and Hobbs, J. IL, Immunochemical studies of the serum, intestinal secretions, and intestinal mucosa in patients with adult celiac disease and other forms of celiac. syndrome. Gastroenterology 69, 414-425 (1970). 

Indications Spleen/kidney vacuity cold, prolonged diarrhea and dysentery. Chronic colitis, chronic diarrhea in children, Crohn s disease, ulcerative colitis, chronic dysentery, celiac syndrome, and pancreatic dysfunction... 

Gastrointestinal diseases < Celiac syndrome 1 Regional enteritis... 

Absorption of fat is seriously impaired in man in the absence of bile from the intestinal tract, for example, in obstructive jaundice, although splitting of fat to fatty acids and glycerol proceeds normally. In sprue, idiopathic steatorrhea, and the celiac syndrome, fat is also poorly absorbed, although there is no decrease in available bile and the enzymatic breakdown to fatty acids is unimpaired. It has been suggested that a defective phosphorylating mechanism, due to deficiency of one or more vitamins of the B complex, may account for poor absorption in the sprue syndrome. Folic acid may be one of the factors involved. 

Calcium deficiency is manifested by tetany with characteristic carpopedal spasm and, at times, laryngospasm and convulsive seizures. When tetany is present, the concentration of serum calcium is usually less than 8 mg. per 100 ml. Tetany occurs in osteomalacia and often accompanies rickets, sprue, the celiac syndrome, and other steatorrheas. 

Noninfectious causes of acute diarrhea include drugs and toxins (Table 18-3), laxative abuse, food intolerance, irritable bowel syndrome (IBS), inflammatory bowel disease, ischemic bowel disease, lactase deficiency, Whipple s disease, pernicious anemia, diabetes mellitus, malabsorption, fecal impaction, diverticulosis, and celiac sprue. 

Celiac disease is the result of the development of inflammatory-allergic condition due to gluten intolerance. The disease occurs both in adults and in children in a number of countries all over the world. Its occurrence is fairly frequent, it is estimated that approximately 1% of the population suffers from it. Patients manifest not only gastrointestinal symptoms, but also symptoms which are the consequence of malabsorption syndrome, such as osteoporosis, hypochromic anemia, hypoproteinaemia, hypocalcemia, short stature in children, vitamin deficiency, secondary polysensibilization, and emotional disturbances. Moreover, it has been observed that the occurrence of autoimmunological diseases and neoplasms in patients who are not treated with gluten-free diet doubles (Swinson et al., 1983 Ventura et al., 1999). 

Normally there is very little fat in the feces. However, fat content in stools may increase because of various fat malabsorption syndromes. Such increased fat excretion is steatorrhea. Decreased fat absorption may be the result of failure to emulsify food contents because of a deficiency in bile salts, as in liver disease or bile duct obstruction (stone or tumor). Pancreatic insufficiency may result in an inadequate pancreatic lipase supply. Finally, absorption itself may be faulty because of damage to intestinal mucosal cells through allergy or infection. An example of allergy-based malabsorption is celiac disease, which is usually associated with gluten intolerance. Gluten is a wheat protein. An example of intestinal infection is tropical sprue, which is often curable with tetracycline. Various vitamin deficiencies may accompany fat malabsorption syndromes. 

Magnesium deftctency, 784, 798, 00-801 Magnesium sulfate, 801-302 Malabsorption syndromes 151 celiac disease, 118,152 Crohn s disease, 152 f Fuctoee, 212... 

Malabsorption Syndromes. Patients at risk include those with celiac disease, tropical sprue, cystic fibrosis, and short bowel syndrome. Excessive intake of oral zinc supplements can cause anemia and hematological abnormalities in the absence of occult blood loss. The copper deficiency is caused by zinc induction of metallothionein in the mtesti-nal mucosa, which then sequesters dietary copper, blocking its absorption. 

In this section, I list diseases and conditions known to cause or accompany magnesium deficiency. My purpose is to show you that one disease can cause others by creating deficiencies that open up a person to other diseases.The following conditions are known to contribute to magnesium deficiency Bartter s syndrome bile insufficiency celiac disease bowel infections vomiting diarrhea alcoholism diabetes high levels of diuretics, vitamin D, or zinc hyperthyroidism metabolic disorders hormone disorders fat metabolism problems colostomy and kidney dysfunctions. 

Malabsorption syndromes (e.g., tropical sprue, celiac disease, radiation enteritis or intestinal lymphectasia)... 

Short stature also occurs with several conditions that are not associated with a trne GH deficiency or insnfficiency. These conditions inclnde intranterine growth restriction constitntional growth delay malnutrition malabsorption of nntrients associated with inflammatory bowel disease, celiac disease, and cystic fibrosis chronic renal failure skeletal and cartilage dysplasia and genetic syndromes... 

Copper deficiency is extremely rare, and there is no evidence that copper ever need be added to a normal diet. Even in chnical states associated with hypocupremia (sprue, celiac disease, and nephrotic syndrome), effects of copper deficiency usually are not demonstrable. Anemia due to copper deficiency has been described in individuals who have undergone intestinal bypass surgery, in those who are receiving parenteral nutrition, in malnourished infants, and in patients ingesting excessive amounts of zinc. While an inherited disorder affecting copper transport (Menkes disease) is associated with reduced activity of several copper-dependent enzymes, this disease is not associated with hematological abnormalities. 

AITD, autoimmune thyroid disease ALPS, autoimmune lymphoproliferative syndrome AS, ankylosing spondylitis CD, celiac disease HSP, Henoch-Schonlein purpura MG, myasthenia gravis RA, rheumatoid arthritis TID, type 1 diabetes. 

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