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villous atrophy

Judit Bajor, Zsolt Szakács, Nelli Farkas, Péter Hegyi, Anita Illés, Margit Solymár, Erika Pétervári, Márta Balaskó, Gabriella Pár, Patrícia Sarlós, Ákos Szűcs, József Czimmer, Kata Szemes, Orsolya Huszár, Péter Varjú, Áron Vincze
BACKGROUND AND AIMS: Experimental data suggest that the HLA-DQ2 gene dose has a strong quantitative effect on clinical outcomes and severity of celiac disease (CD). We aimed to conduct a meta-analysis with systematic review to investigate the association between HLA-DQB1*02 gene doses and the characteristics of CD. METHODS: We searched seven medical databases for studies discussing HLA-DQB1 gene dose in CD and various disease characteristics, such as clinical presentation, histology, age at diagnosis, and comorbidities...
2019: PloS One
Paulina Henry, Hélène Dano, Hubert Piessevaux, Anne Jouret-Mourin
Olmesartan induced enteropathy was first described in 2012. It is a rare adverse effect of this antihypertensive drug. The clinical presentation commonly includes severe chronic diarrhea leading to weight loss and a variable degree of dehydration. Histological findings are most commonly observed in the duodenum and consist of partial or total villous atrophy, increased intraepithelial lymphocytes and inflammation in the lamina propria. Involvement of gastric and colic mucosa has also been described. We report on the case of a 63-year-old man, treated by olmesartan, who presented with severe chronic diarrhea...
January 31, 2019: Annales de Pathologie
Georgia Malamut, Christophe Cellier
Refractory celiac disease (RCD) refers to persistence of malnutrition and intestinal villous atrophy for more than 1 to 2 years despite strict gluten-free diet in patients with celiac disease. Diagnosis remains difficult and impacts treatment and follow-up. RCD has been subdivided into 2 subgroups according to the normal (RCDI) or abnormal phenotype of intraepithelial lymphocytes (IELs) (RCDII). RCDII is considered as a low-grade intraepithelial lymphoma and has a poor prognosis due to gastrointestinal and extraintestinal dissemination of the abnormal IELs, and high risk of overt lymphoma...
March 2019: Gastroenterology Clinics of North America
Qiuhong Wang, Anastasia N Vlasova, Scott P Kenney, Linda J Saif
Porcine epidemic diarrhea virus (PEDV), porcine deltacoronavirus (PDCoV), and swine acute diarrhea syndrome-coronavirus (SADS-CoV) are emerging/reemerging coronaviruses (CoVs). They cause acute gastroenteritis in neonatal piglets. Sequence analyses suggest that PEDV and SADS-CoV may have originated from bat CoVs and PDCoV from a sparrow CoV, reaffirming the interspecies transmission of CoVs. The clinical signs and pathogenesis of the three viruses are similar. Necrosis of infected intestinal epithelial cells occurs, causing villous atrophy that results in malabsorptive diarrhea...
January 14, 2019: Current Opinion in Virology
Edward J Ciaccio, Suzanne K Lewis, Govind Bhagat, Peter H Green
BACKGROUND: Videocapsule endoscopy images are useful to detect pathologic alterations, including villous atrophy, in the small intestinal mucosa, which is helpful for diagnosing celiac disease. In prior work, quantitative videocapsule analysis was found useful to classify celiac versus control images. However, the effect of dark/extraneous substances on classification efficacy requires remediation. METHOD: For quantitative analysis, data from the Medtronic SB2 and SB3 systems were pooled...
December 24, 2018: Computers in Biology and Medicine
Makiko Kawaguchi, Koji Yamamoto, Naoki Takeda, Tsuyoshi Fukushima, Fumiki Yamashita, Katsuaki Sato, Kenichiro Kitamura, Yoshitaka Hippo, James W Janetka, Hiroaki Kataoka
Mutations in SPINT2 encoding the epithelial serine protease inhibitor hepatocyte growth factor activator inhibitor-2 (HAI-2) are associated with congenital tufting enteropathy. However, the functions of HAI-2 in vivo are poorly understood. Here we used tamoxifen-induced Cre-LoxP recombination in mice to ablate Spint2 . Mice lacking Spint2 died within 6 days after initiating tamoxifen treatment and showed severe epithelial damage in the whole intestinal tracts, and, to a lesser extent, the extrahepatic bile duct...
2019: Communications biology
Jenan Ghaith, Ismail A Raslan, Andrew Szilagyi, Mona Alameldin
Olmesartan-associated enteropathy (OAE) is increasingly being recognised as a major differential diagnosis in patients with villous atrophy and negative coeliac disease (CD) serology. OAE and positive coeliac markers have rarely been reported. We report a case of diarrhoea and small bowel villous blunting associated with a transient elevation of antitissue transglutaminase antibody (ATTG). On discontinuation of olmesartan, symptoms improved, repeat biopsies were normal and levels of ATTG also returned normal...
December 13, 2018: BMJ Case Reports
Annalisa Schiepatti, David S Sanders, Martina Zuffada, Ombretta Luinetti, Adam Iraqi, Federico Biagi
Differential diagnosis and management of enteropathies found in the context of seronegative villous atrophy (VA) are still a clinical challenge. Although seronegative coeliac disease may be the most frequent cause of serology-negative VA, other conditions must be taken into account in the differential diagnosis of seronegative VA. The rarity of these enteropathies with frequent overlapping of histological features may result in misclassification of such patients as affected by a seronegative or a refractory form of coeliac disease with consequent inappropriate treatments and long-term morbidity...
December 14, 2018: European Journal of Gastroenterology & Hepatology
L M M Costes, D J Lindenbergh-Kortleve, L A van Berkel, S Veenbergen, H R C Raatgeep, Y Simons-Oosterhuis, D H van Haaften, J J Karrich, J C Escher, M Groeneweg, B E Clausen, T Cupedo, J N Samsom
Breach of tolerance to gluten leads to the chronic small intestinal enteropathy celiac disease. A key event in celiac disease development is gluten-dependent infiltration of activated cytotoxic intraepithelial lymphocytes (IELs), which cytolyze epithelial cells causing crypt hyperplasia and villous atrophy. The mechanisms leading to gluten-dependent small intestinal IEL infiltration and activation remain elusive. We have demonstrated that under homeostatic conditions in mice, gluten drives the differentiation of anti-inflammatory T cells producing large amounts of the immunosuppressive cytokine interleukin-10 (IL-10)...
December 12, 2018: Mucosal Immunology
Roxana Maxim, Alina Plesa, Carol Stanciu, Irina Girleanu, Evelina Moraru, Anca Trifan
BACKGROUND/AIMS: The relationship between Helicobacter pylori and celiac disease (CD) remains controversial. The aim of this study was to assess the prevalence and risk factors for H. pylori infection among children diagnosed with CD. MATERIALS AND METHODS: This study included 70 patients diagnosed with CD at a tertiary referral center in Romania. Age, gender, and indicators of environmental conditions were evaluated via interviews with the childrens caretakers...
December 12, 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Luca Elli, Francesca Ferretti, Stefania Orlando, Maurizio Vecchi, Erika Monguzzi, Leda Roncoroni, Detlef Schuppan
Celiac disease (CD) is the most common autoimmune enteropathy worldwide. In CD, dietary gluten triggers a T cell driven small intestinal inflammation in a subset of genetically predisposed subjects, expressing the HLA DQ2 and/or DQ8 genes on their antigen presenting cells. HLA DQ2/DQ8 can bind gluten peptides after their prior modification by the CD autoantigen, tissue transglutaminase (TG2). This process leads to the activation of gluten reactive T cells, small bowel villous atrophy, crypt hyperplasia and intraepithelial lymphocytosis, the histological hallmarks of CD...
December 5, 2018: European Journal of Internal Medicine
Minna Hietikko, Outi Koskinen, Kalle Kurppa, Kaija Laurila, Päivi Saavalainen, Teea Salmi, Tuire Ilus, Heini Huhtala, Katri Kaukinen, Katri Lindfors
BACKGROUND: In coeliac disease, ingestion of gluten induces the production of transglutaminase 2 (TG2)-targeted autoantibodies by TG2-specific plasma cells present at high frequency in the small intestinal mucosa in untreated disease. During treatment with a gluten-free diet (GFD), the number of these cells decreases considerably. It has not been previously investigated whether the cells are also present prior to development of villous atrophy, or in non-responsive patients and those with dietary lapses...
December 6, 2018: BMC Immunology
Javier Lucas Ramos, Pedro de María Pallarés, Álvaro Pezzela Risueño
Mycophenolate mofetil (MMF) is an immunosuppressive agent that is used in transplanted patients, with frequent gastrointestinal adverse effects. We report the case of a patient, under chronic therapy with mycophenolate mofetil , during a diagnostic workup for a chronic diarrhea, which presents a duodenal villous atrophy ( VA) with negative celiac serology, which is a diagnostic challenge. VA secondary to MMF is a very unusual adverse effect. Just a few cases have been reported in the literature.
December 4, 2018: Revista Española de Enfermedades Digestivas
Neha Berry, Jahangeer Basha, Neelam Varma, Subhash Varma, Kaushal Kishor Prasad, Kim Vaiphei, Narendra Dhaka, Saroj K Sinha, Rakesh Kochhar
Background and Aims: Anemia is one of the most common extraintestinal manifestations of celiac disease (CD), with iron deficiency anemia (IDA) being the predominant cause. However, anemia in CD can have varied etiologies, including mixed nutritional deficiency. We aimed to study the prevalence and etiology of anemia in CD in a north Indian population. Methods: In this prospective observational study, consecutive patients with documented CD between January 2012 and December 2013 were included, and all patients underwent detailed clinical assessment; hematological investigations including iron profile, serum folate, and vitamin B12 levels; and esophageoduodenoscopy with duodenal biopsies for histopathological examination...
October 2018: JGH open: an open access journal of gastroenterology and hepatology
Claire L Jansson-Knodell, Isabel A Hujoel, Colin P West, Veena Taneja, Larry J Prokop, Alberto Rubio-Tapia, Joseph A Murray
BACKGROUND AND AIMS: A higher proportion of female vs male patients receive a diagnosis of celiac disease. Little is known about sex-based differences in the prevalence of celiac disease in undiagnosed populations. We aimed to address this knowledge gap with a systematic review and meta-analysis. METHODS: We searched MEDLINE, Embase, Cochrane, and Scopus databases through 2017 for studies of screen-detected or undiagnosed celiac disease. Our final analysis included studies that included screening and confirmatory tests (either second serologic analysis or a small intestine biopsy) and provided information on sex of participants...
November 15, 2018: Clinical Gastroenterology and Hepatology
Pavel Frühauf, N Nabil El-Lababidi, Peter Szitányi
Celiac disease can be defined as a small bowel disorder characterized by mucosal inflammation, villous atrophy and crypt hyperplasia, which occurs upon exposure to dietary gluten and which demonstrates improvement after withdrawal of gluten from the diet. Keywords: celiac disease, children, adolescents.
2018: Casopís Lékar̆ů C̆eských
Manuel Valero, Gladys Bravo-Velez, Roberto Oleas, Miguel Puga-Tejada, Miguel Soria-Alcívar, Haydee Alvarado Escobar, Jorge Baquerizo-Burgos, Hannah Pitanga-Lukashok, Carlos Robles-Medranda
BACKGROUND/AIMS: Capsule endoscopy is a diagnostic method for evaluating the small bowel lumen and can detect undiagnosed lesions. The aim of this study was to evaluate the diagnostic yield and clinical impact of capsule endoscopy in patients with refractory diarrhea-predominant irritable bowel syndrome and functional abdominal pain. METHODS: This study involved a retrospective analysis of prospectively collected data, maintained in a database. Patients with refractory diarrhea-predominant irritable bowel syndrome and functional abdominal pain within the period of March 2012 to March 2014 were included...
November 2018: Clinical Endoscopy
Vito Domenico Corleto, Vincenza Patrizia Di Marino, Gloria Galli, Giulio Antonelli, Chiara Coluccio, Arcangelo Di Cerbo, Stefania Uccini, Bruno Annibale
BACKGROUND: The diagnosis of Coeliac disease (CD) requires a combination of sign/symptoms, positivity of specific antibodies and duodenal histological evidence of villous atrophy. Duodenal villous atrophy, despite representing the CD landmark, is not specific since it is found in many gastrointestinal disorders. Giardiasis is one of the most common human intestinal protozoan infestations in industrialized countries whose histological duodenal mucosa damage could mimic that of CD. The present report shows how a wise clinical and laboratory assessment led us shortly to a correct diagnosis...
November 3, 2018: BMC Gastroenterology
Itay Tokatly Latzer, Liat Lerner-Geva, Daniel Stein, Batia Weiss, Orit Pinhas-Hamiel
PURPOSE: Celiac disease (CD) is a chronic immune-mediated systemic disease characterized by inflammation and villous atrophy of the small intestine. A strict, lifelong gluten-free diet (GFD) is the only treatment for CD. Disordered eating behaviors (DEBs) prevail in adolescence and young adulthood, and confer a risk of developing into full-blown eating disorders. The aims of the current study were to assess the incidence and risk factors for DEBs among individuals with CD, and to examine an association between adherence to GFD and DEBs...
October 27, 2018: Eating and Weight Disorders: EWD
Hey-Long Ching, Melissa F Hale, Matthew Kurien, Jennifer A Campbell, Stefania Chetcuti Zammit, Ailish Healy, Victoria Thurston, John M Hebden, Reena Sidhu, Mark E McAlindon
BACKGROUND:  Small-bowel capsule endoscopy is advocated and repeat upper gastrointestinal (GI) endoscopy should be considered for evaluation of recurrent or refractory iron deficiency anemia (IDA). A new device that allows magnetic steering of the capsule around the stomach (magnetically assisted capsule endoscopy [MACE]), followed by passive small-bowel examination might satisfy both requirements in a single procedure. METHODS:  In this prospective cohort study, MACE and esophagogastroduodenoscopy (EGD) were performed in patients with recurrent or refractory IDA...
October 25, 2018: Endoscopy
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