Celiac Disease in Primary Care. Dustin M Adkins Spring 2007. Essentials of Celiac Disease. Autoimmune disorder triggered by gluten “Gluten” is a collective term for the storage proteins of wheat, rye, and barley. Adaptive/innate immune response damages villi in the proximal small intestine
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Dustin M Adkins
Summary of the clinical presentation of celiac disease. Included 170 biopsy-diagnosed celiac disease patients diagnosed between 1993 and 2000 (Lo 2003).
Autoimmune (10-fold with Celiac Disease. Only in a minority of patients.↑)
Type I Diabetes (1-12%)
Autoimmune liver disease
Other related disorders
Down syndrome (3-12%)
Neuropsychiatric d/o’sAssociated Disorders (HLA DQ2/DQ8)
Difficult task for the patient. with Celiac Disease. Only in a minority of patients.
Should see a registered dietician
Complicated by fast-food lifestyles, hidden ingredients, poor labeling, and costly/unavailable specialty foods.
Lifelong diet normalizes mortality/comborbidity risksTreatment: Lifelong Gluten-Free Diet
Never advise a patient to start a Gluten-Free Diet before biopsy!
It alters the histopathology requiring additional testing ($$$), and ticks off the gastroenterologist!
Modified Food Starch