All Boards >> Irritable Bowel Syndrome Research Library

HeatherAdministrator

Reged: 12/09/02
Posts: 7681
Loc: Seattle, WA
Children with silent celiac
      06/19/15 03:06 PM



"Silent" celiac disease (CD), or CD without gastrointestinal symptoms, was present in 2.0% of children presenting for initial pediatric rheumatology evaluation, researchers from the Hospital for Special Surgery, New York City, report in an article published online June 15 in Pediatrics. The authors say celiac testing should be included in the standard initial laboratory workup for pediatric rheumatology patients, as they found that initiation of a gluten-free diet led to resolution of musculoskeletal symptoms in many of the affected patients.

Yekaterina Sherman, BA, and a research team led by Thomas J. A. Lehman, MD, retrospectively reviewed medical charts and data from standardized serologic screening for 2125 patients (age, 2 - 16 years) who presented for care at the Hospital for Special Surgery, Division of Pediatric Rheumatology, between June 2006 and December 2013. The researchers found that 36 patients had previously unsuspected CD. Together with the eight patients known to have CD at study entry, the prevalence of CD during the 6.5-year study period was 2.0%, or about 1 in 48 patients. Prevalence in the general population was 0.7%.

Thirty of the 36 "silent CD" cases were confirmed by endoscopy. Six refused endoscopy but had significant reduction of symptoms with a gluten-free diet.

"The majority of the newly diagnosed CD cases, 22 out of 36 (61.1%), presented with musculoskeletal complaints alone and none of the classic symptoms of CD, such as abdominal pain, short stature, weight loss, and failure to thrive,” the authors write. “In fact, only 12 patients reported a history of [gastrointestinal]-related complaints." They note that these data provide further evidence that symptom-based case finding will miss the majority of CD cases in children.

Pediatric CD Guidelines Need a Rewrite

The researchers suggest that current clinical guidelines for CD screening published by the American College of Gastroenterology and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition be revised to include children with musculoskeletal complaints.

Current guidelines do not consider such patients to be a high-risk group and do not specifically recommend screening of this population. The guidelines recommend CD screening for children with failure to thrive, persistent diarrhea, recurrent abdominal pain, constipation and vomiting, dermatitis herpetiformis, dental enamel hypoplasia, osteoporosis, short stature, delayed puberty, iron-deficient anemia, asymptomatic diabetes mellitus, autoimmune thyroiditis, Down syndrome, Turner syndrome, Williams syndrome, selective immunoglobulin A deficiency, and a history of a first-degree relative with CD.

Clinicians using the current guidelines rather than screening all children with musculoskeletal complaints would have missed all but six of the asymptomatic CD cases in the study population. The authors note that prompt detection of CD would not only enable the patient to achieve the benefits of early initiation of a gluten-free diet but also avoid the dangers of unnecessary immunosuppressive therapy.

If CD Is Present, Is This Really Idiopathic Arthritis?

The association between CD and musculoskeletal complaints raised a further interesting question: Is this really "idiopathic arthritis" if it resolves with treatment of CD?

"Our data suggest that there may be a subset of patients with 'silent' CD who present with isolated musculoskeletal symptoms and that perhaps [juvenile idiopathic arthritis] is not an appropriate diagnosis in these cases. Clinicians must be vigilant in cases such as these to evaluate appropriately for CD," the authors note.

The authors have disclosed no relevant financial relationships.

Pediatrics. Published online June 15, 2015.

http://www.medscape.com/viewarticle/846467

--------------------
Heather is the Administrator of the IBS Message Boards. She’s the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

Post Extras Print Post   Remind Me!     Notify Moderator

Entire thread
Subject Posted by Posted on
* Celiac / Gluten Intolerance HeatherAdministrator 07/14/03 01:59 PM
. * Fructans Suspect in Non-Celiac Gluten Sensitivity HeatherAdministrator   03/19/18 02:44 PM
. * Relatives, spouses of celiac disease patients at risk for autoimmune disease HeatherAdministrator   07/09/15 03:39 PM
. * Children with silent celiac HeatherAdministrator   06/19/15 03:06 PM
. * Delays in gluten introduction, onset of celiac disease in at-risk infants linked HeatherAdministrator   10/07/14 02:23 PM
. * Evidence points to Monsanto Roundup as culprit in rise of gluten intolerance & IBS HeatherAdministrator   02/19/14 01:30 PM
. * New approach to celiac testing identifies more at risk HeatherAdministrator   08/30/13 12:11 PM
. * Is a Gluten-Free Diet Right for You? HeatherAdministrator   08/16/13 02:15 PM
. * FDA Defines ‘Gluten-free’ for Food Labels HeatherAdministrator   08/07/13 10:49 AM
. * Tooth damage may be a sign of celiac disease HeatherAdministrator   06/11/13 03:47 PM
. * The Gluten-Free Vegetarian — Not to Worry, the Food Options Are Plentiful HeatherAdministrator   04/17/13 12:01 PM
. * Gluten-Free, Whether You Need It or Not HeatherAdministrator   02/08/13 11:27 AM
. * Non-celiac gluten sensitivity less common than celiac disease HeatherAdministrator   10/31/12 11:32 AM
. * Most Cases of Non-Responsive Celiac Disease Due to Ongoing Gluten Consumption HeatherAdministrator   06/15/12 03:08 PM
. * The good and the bad of going gluten free HeatherAdministrator   06/15/12 01:18 PM
. * Weird!! Patients with Non-celiac Gluten Sensitivity Report More Symptoms than Those with Celiac Disease HeatherAdministrator   06/15/12 01:12 PM
. * Irritable Bowel Syndrome and Gluten Sensitivity Without Celiac Disease HeatherAdministrator   05/17/12 12:13 PM
. * Celiac disease is more common in older adults HeatherAdministrator   04/23/12 01:40 PM
. * Celiac Disease on the Rise in U.S. - from sanitation and hygiene? HeatherAdministrator   08/24/11 02:41 PM
. * Birth Month Seems to Be Linked to Celiac Disease HeatherAdministrator   05/09/11 11:50 AM
. * More People May Benefit From Going Gluten-Free HeatherAdministrator   05/09/11 11:44 AM
. * Gluten Causes Gastrointestinal Symptoms in Subjects Without Celiac Disease HeatherAdministrator   01/13/11 01:01 PM
. * Celiac Disease Is Increasing Worldwide HeatherAdministrator   08/04/10 11:57 AM
. * Gluten intolerance versus celiac disease HeatherAdministrator   04/14/10 10:27 AM
. * Celiac disease may strike elderly, too HeatherAdministrator   03/11/10 01:19 PM
. * Gene links to celiac disease may help drug search HeatherAdministrator   03/11/10 12:57 PM
. * Genetic links to celiac disease identified HeatherAdministrator   03/05/10 02:36 PM
. * People on gluten-free diets benefit from oats HeatherAdministrator   03/05/10 12:23 PM
. * Between Celiac Disease and Irritable Bowel Syndrome HeatherAdministrator   03/05/10 11:49 AM
. * Study confirms four-fold increase in wheat gluten disorder HeatherAdministrator   07/22/09 01:15 PM
. * Effect of gluten-free diet and co-morbidity of irritable bowel syndrome-type symptoms on celiac patients HeatherAdministrator   03/18/09 05:46 PM
. * Gluten-Free Diet in Patients Diagnosed With Diarrhea-Predominant Irritable Bowel Syndrome HeatherAdministrator   07/17/07 11:18 AM
. * Non-Toxic Wheat May Be an Answer to Celiac Disease HeatherAdministrator   10/28/05 11:57 AM
. * Babies at Celiac Disease Risk Should Wait for Wheat HeatherAdministrator   06/20/05 04:24 PM
. * Relief for celiac patients HeatherAdministrator   06/05/05 05:48 PM
. * Gastrointestinal Motility Disturbances in Celiac Disease. HeatherAdministrator   09/12/04 03:27 PM
. * Celiac Disease: Where We Are and Where We Are Going HeatherAdministrator   06/27/04 01:58 PM
. * No Link Apparent Between IBS and Celiac Disease HeatherAdministrator   04/27/04 09:01 PM
. * Oats Safe for Celiac in Children HeatherAdministrator   04/26/04 01:08 PM
. * Celiac disease is a risk factor for schizophrenia HeatherAdministrator   02/24/04 02:13 PM
. * Against the grain: The growing awareness of celiac sprue HeatherAdministrator   08/12/03 12:12 PM
. * Celiac disease: fertility and pregnancy. HeatherAdministrator   07/15/03 06:14 PM
. * Celiac disease and spontaneous abortion HeatherAdministrator   07/15/03 06:12 PM
. * Is it necessary to screen for celiac disease in postmenopausal osteoporotic women? HeatherAdministrator   07/15/03 06:09 PM
. * Celiac Disease: More Common Than You Think HeatherAdministrator   07/14/03 04:15 PM
. * High prevalence of small intestinal bacterial overgrowth in celiac patients HeatherAdministrator   07/14/03 03:04 PM

Extra information
0 registered and 4 anonymous users are browsing this forum.

Moderator:  Heather 



Permissions
      You cannot post until you login
      You cannot reply until you login
      HTML is enabled
      UBBCode is enabled

Thread views: 123859

Jump to

| Privacy statement Help for IBS Home

*
UBB.threads™ 6.2


Shop For IBS Here!