Gluten sensitivity

B13. Best, C. N., and Cook, P. B., Case of mesenteric reticulosarcoma associated with gluten-sensitive steatorrhea. Brit. Med. J. II, 496-498 (1961). 

HV165 Vainio E., and E. Varjonen. Antibody response against wheat, rye, barley, oats and com comparison between gluten-sensitive patients and monoclonal antigliadin antibodies. Int Arch Allergy Immunol 1995 106(2) 134-138. 

Marsh, M.N., Morgan, S., Ensari, A., Wardle, T., Lobley, R., Mills, C., Auricchio, S. 1995. In vivo activity of peptide 31 —43,44—55,56-68 of alfa-gliadin in gluten sensitive entherop-athy (GSE). Gastroenterology 108 A871. 

Marsh MN. Gluten, major histocompatibility complex, and the small intestine. A molecular and immunobiologic approach to the spectrum of gluten sensitivity ( celiac sprue ). Gastroenterol 1992 102 330-354. 

Burk K, Bosch S, Muller CA, Melms A, Ziihlke C, Stern M, et al. Sporadic cerebellar ataxia associated with gluten sensitivity. Brain 2001 124 1013-1019. 

Anheim M, Degos B, Echaniz-Laguna A, Fleury M, Grucker M, Tranchant C. Ataxia associated with gluten sensitivity, myth or reality Rev Neurol (Paris) 2006 162 214-221. 

Sardy M, Odenthal U, Karpati S, Paulsson M, Smyth N. Recombinant human tissue transglutaminase ELISA for the diagnosis of gluten-sensitive enteropathy. Clin Chem 1999 45 2142-2149. 

The high diagnostic accuracy of autoantibody tests for CD has questioned the need for intestinal biopsy [128], especially in pediatric populations [129]. Because histological and serological examination has limitations (and also HLA typing, an expensive procedure not suitable for routine diagnostic use), it is still advised to apply a combination to clarify the full breadth of the gluten-sensitive spectrum [130]. 

Chloe s medical notes show that as an infant she was admitted to the children s hospital with suspected celiac disease (gluten-sensitive enteropathy). On discharge, she was prescribed a special diet for four years. Her paediatrician then suggested the gradual introduction of foods previously excluded from her diet, such as bread and breakfast cereals. Since then she has gained weight normally and remained fairly well, except for occasional anaemia. Her blood test now shows microcytic red blood cells some of her biochemical results are shown below. 

Gluten-sensitive enteropahy A subject with gluten enteropathy was tested While tiospitalized with this disease he had been found to have a plasma Zn of < 5 yg/dl (1S)> It was desired to determine if he had abnormal Zn absorption or was Zn-deficient due to the diarrhea and malnutrition of his disease We found that he had normal absorption of Zn Fe and Cu from Trutol (Table IV) while on a gluten-free diet. 

Metal Absorption by a Subject with Gluten Sensitive Enteropathy... 

Malabsorption syndromes. Particularly in gluten-sensitive enteropathy and tropical sprue, poor absorption of folic acid from the small intestine often leads to a megaloblastic anaemia. 

Glutafin Gluten-sensitive enteropathies, N/A British National... 

You may wish to advise the patient of other items that are available on NHS prescription forms for patients with gluten sensitive enteropathies. Where would you find the necessary information Information as to which products can be prescribed on an NHS prescription can be found by consulting the Drug Tariff (see Section 2.4). Specific foods (i.e. borderline substances) can be found in the respective parts of the Drug Tariff for England and Wales (see Section 2.4.1, Part XV) or the Northern Ireland Drug Tariff (see Section 2.4.2, Part X) or in Appendix 7 of the British National Formulary (see Section 2.6.1). 

Celiac Disease (Celiac Sprue, Gluten-Sensitive... 

Celiac disease is sometimes called nontropical sprue, cefiac sprue, or gluten-sensitive enteropathy. 

Toxic dysgammaglobulinemia Prolonged uremia Gluten-sensitive enteropathy Diabetes mellitus without proteinuria Following severe infection Rubella in utero Cytotoxic therapy... 

Carbohydrate malabsorption can occur in a number of diseases that cause mucosal damage or dysfunction (e.g., gastroenteritis, protein deficiency, gluten-sensitive enteropathy). Disorders due to deficiencies of specific oligosaccharidases are discussed below. 

In patients with vitamin D deficiency, oral vitamin D 50,000 units daily for 10 days or once weekly for 8 weeks, or 50,000 to 500,000 units intramuscularly is recommended. Serum calcium and 25(OH) vitamin D should be monitored periodically. Once replete, daily intakes of 600 to 1000 units are usually required. In the community or nursing home, vitamin D 100,000 units once per quarter is reasonable. In patients with vitamin D malabsorption (e.g., gluten-sensitive celiac sprue), 25(OH) vitamin D (calcidiol) administration is needed. In patients with severe hepatic or renal disease, calcitriol therapy may be required. This drug requires careful titration and serum calcium and creatinine monitoring because of its hypercalcemic potential and the limited calciuric ability of the dysfunctional kidney. 

Intestinal T-cell lymphoma most often occurs in patients with gluten-sensitive enteropathy and presents with refractory, perforating ulcers in the jejunum. A mass may or may not be evident. The histology is heterogeneous, although a subset of cases comprises monomorphic medium-sized cells. Tropism for the epithelium is usually marked. Most of the intestinal lymphocytes exhibit a cytotoxic T-cell phenotype (TIA-1 and granzyme B positive) with CD56 expression relatively infrequent. 464,265 infection as assessed... 

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