Celiac disease

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Celiac disease

: Endocr Pract. 2008 Apr;14(3):381-8.Related Articles, Links

Celiac disease and the endocrinologist: a diagnostic opportunity.

Fisher AH, Lomasky SJ, Fisher MJ, Oppenheim YL.

Endocrinology and Diabetes Associates of Long Island, Rockville Centre, New York 11570, USA.

OBJECTIVE: To review the association of celiac disease and various endocrine disorders and present the related clinical experience of a 3-physician adult endocrinology practice. METHODS: We provide an overview of the pertinent literature, discuss the clinical manifestations, genetics, and pathogenesis of celiac disease, and describe our clinical experience during a 5-year period. RESULTS: Celiac disease has been associated with numerous disorders, including several conditions treated by endocrinologists-type 1 diabetes mellitus, autoimmuneA condition or disease thought to arise from an overactive immune response of the body against substances and tissues normally present in the body thyroid disease, Addison disease, osteomalacia, secondary hyperparathyroidism, vitamin D or iron deficiency, fertility problems, hypogonadism in men, and autoimmune hypopituitarism. After our clinical awareness was raised about these potential comorbidities, 18 patients were newly diagnosed with celiac disease in our clinical practice during a 5-year interval. All patients had been referred for endocrine evaluation or were undergoing follow-up for ongoing management of endocrine disorders. When a “celiac-associated” endocrine disorder coexists with other factors associated with celiac disease, we recommend performance of IgA class antibody testing, and either antiendomysial or anti-tissue transglutaminase antibodies provide high specificity and sensitivity for the diagnosis of celiac disease. CONCLUSION: Endocrinologists have an opportunity to diagnose celiac disease, a relatively common disorder with profound clinical implications that can often be associated with various endocrinopathies.

Publication Types: Review

PMID: 18463048

Celiac and D metabolite levels

Some patients with celiac disease have low/normal 25D but elevated 1,25D apparently related to celiac. For examples, see PubMed articles 8186825 and 15310538

Quoting 15310538, “Our patient had hypocalcemia caused by celiac disease and values for serum 25-hydroxyvitamin DThe vitamin D metabolite widely (and erroneously) considered best indicator of vitamin D "deficiency." Inactivates the Vitamin D Nuclear Receptor. Produced by hydroxylation of vitamin D3 in the liver. and 1,25-dihydroxyvitamin DPrimary biologically active vitamin D hormone. Activates the vitamin D nuclear receptor. Produced by hydroxylation of 25-D. Also known as 1,25-dihydroxycholecalciferol, 1,25-hydroxyvitamin D and calcitirol. that were normal and elevated, respectively. Correction was demonstrated after dietary gluten withdrawal.”

Evidence of infectious cause

Sample PubMed cite¹

Specific duodenal and faecal bacterial groups are associated with paediatric celiac disease.²

Lymphocytic gastritis and celiac disease in indian children: evidence of a positive relation.³

Notes and comments

===== Symptoms ===== ===== Management ===== ===== Other treatments ===== ===== Tests ===== ===== Diagnosis ===== ===== Epidemiology ===== ===== Types ===== ===== Evidence of infectious cause===== ===== Role of vitamin D metabolism ===== ===== Politics ===== ===== Patient interviews ===== ===== Presentations and publications=====

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References

¹⁾ Marshall TG Vitamin D discovery outpaces FDA decision making. Bioessays. 2008;30:173-82.

²⁾ Collado MC, Donat E, Ribes-Koninckx C, Calabuig M, Sanz Y Specific duodenal and faecal bacterial groups associated with paediatric coeliac disease. J Clin Pathol. 2009;62:264-9.

³⁾ Prasad KK, Thapa BR, Lal S, Sharma AK, Nain CK, Singh K Lymphocytic gastritis and celiac disease in indian children: evidence of a positive relation. J Pediatr Gastroenterol Nutr. 2008;47:568-72.

Last modified: 05.31.2010