celiac sprue


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Related to celiac sprue: celiac disease

sprue

 [sproo]
a chronic form of malabsorption syndrome occurring in both tropical and nontropical forms.
celiac sprue (nontropical sprue) celiac disease.
tropical sprue a chronic disease affecting the digestive system, marked by imperfect absorption of food elements, especially fat, xylose, and vitamin B12, from the small intestine. It is closely related to celiac disease and may be identical to it.



The name sprue derives from a Dutch word describing inflammation of the mouth, which is a frequent symptom. The disease has been recognized for more than 2000 years. It occurs mostly, but not exclusively, in the tropics.
Symptoms and Treatment. Symptoms are loss of appetite, flatulence, anemia, diarrhea, stomach cramps, and extreme loss of weight. Stools are usually pale, greasy, unformed, and foul-smelling, but at times become watery. If a deficiency of vitamin B complex is also present, cracks develop at the corners of the mouth and the tongue becomes smooth, glossy, and bright red.



Treatment consists of a special diet of foods that are low in fat and high in protein. Diets free of gluten, a viscid grain protein, may be prescribed. Liver preparations, folic acid, calcium lactate tablets, vitamin B12, and iron supplements to provide food elements that are not absorbed, as well as skim milk and ripe bananas, have produced favorable results. Antibiotics have proved temporarily successful, but their prolonged use is not recommended.

Cases of sprue that are recognized early respond better to treatment than do cases of long standing. Appetite and weight return rapidly. The time required for complete recovery is prolonged, however, especially in extreme cases.

ce·li·ac dis·ease

[MIM*212750]
a disease occurring in children and adults characterized by sensitivity to gluten, with chronic inflammation and atrophy of the mucosa of the upper small intestine; manifestations include diarrhea, malabsorption, steatorrhea, nutritional and vitamin deficiencies, and failure to thrive, or short stature.

celiac sprue

coeliac disease

A malabsorptive syndrome caused by hypersensitivity of intestinal mucosa to alpha-gliadin, a gluten extract composed of glutamine and proline-rich proteins that is found in wheat, barley, rye, and oats.
 
Clinical findings
Diarrhoea, copious fatty stools, abdominal distension, weight loss, haemorrhage, osteopenia, muscle atrophy, peripheral neuropathy, CNS and spinal cord demyelination (sensory loss, ataxia), amenorrhoea, infertility, oedema, petechiae, dermatitis herpetiformis (especially if HLA B27), alopecia areata. Occult bleeding occurs in half of patients.
 
Lab
Transaminases (ALT, AST) are increased in ± 40% of patients with CD, which usually normalises with a gluten-free diet; iron deficiency, anaemia due to occult bleeding.

Diagnosis
Duodenal biopsy; anti-gliadin and anti-endomysial antibodies.
 
Management
Eliminate gliadin from diet.

Prognosis
Without treatment, 10–15% develop lymphoma (e.g., immunoblastic lymphoma; less commonly, T cell lymphoma), a risk that increases with disease duration. CD predisposes to gastrointestinal lymphoma and carcinoma of the oral cavity and oesophagus; the otherwise rare small intestinal adenocarcinoma is 80-fold more common in CD.

celiac sprue (sē´lēak sprōō),

n a genetic disorder in which the body cannot digest certain gluten proteins found in wheat, barley, rye, and oats. This leads to inflammation and flattening of the wall of the small intestine and a reduction in the body's ability to absorb nutrients. Also known as
celiac disease (CD).

Patient discussion about celiac sprue

Q. Is celiac genetic? I have one son with celiac disease from my first marriage and me second wife is now pregnant,I was wondering what are the chances for this soon to be born daughter of mine to have celiac as well- if I maybe carry the genetic flaw and is there a way to find out?

A. Celiac disease is a very common illness (about 1 in a 100 people suffer from it in different levels), and it is known to have a strong genetic connection. However, there is not one specific mutation that you can get genetic testing to see if you are carrying it. Your soon to be born daughter will have a higher chance than the regular population to suffer from the disease, but it does not necessarily mean she will.

Q. How do you diagnose celiac? My daughter is 3 years old and is constantly vomiting, has diarrhea and stomach aches. Could this be celiac?

A. This could in fact be celiac. The initial step in screening should include: IgA endomysial antibodies (EMA), IgA tissue transglutaminase (tTG), IgG tissue transglutaminase and Total IgA antibodies. The patients with positive antibody tests, and those with an IgA deficiency, should have a small bowel biopsy to confirm the diagnosis and assess the degree of damage, which is performed endoscopically (looking inside the body by inserting a tube into it).

Q. Is FTT a symptom of celiac? My 1.5 year old son has FTT (failure to thrive) and stomach aches. What could be causing it?

A. Failure to thrive lacks a precise definition, in part because it describes a condition rather than a specific disease. Children who fail to thrive don't receive or are unable to take in, retain, or utilize the calories needed to gain weight and grow as expected. FTT can be caused from many different things: social factors, conditions involving the gastrointestinal system like gastroesophageal reflux, chronic diarrhea, cystic fibrosis, chronic liver disease, and celiac disease. From a chronic illness or medical disorder, an intolerance of milk protein, infections or metabolic disorders.

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References in periodicals archive ?
Schoenfeld said that he prefers to test for serum celiac sprue using the tissue transglutaminase antibody test, because its sensitivity is almost 100%.
Testing for celiac sprue in irritable bowel syndrome with predominant diarrhea: a cost-effectiveness analysis.
Our goals are to understand the biochemical basis of celiac sprue, and to translate these insights into pharmacological agents that could allow patients to safely reincorporate these otherwise nutritious and extremely common food grains into their diet," he says.
Chaitan Khosla and his colleagues at Stanford University and the University of Norway in Oslo report identifying a single component of gluten proteins that causes the autoimmune response characteristic of celiac sprue.
are allergic to wheat or are diagnosed with celiac sprue, according to Regal.
Blame bleeding: A Dallas researcher is reporting that at least half of all people with celiac sprue - a disease in which people cannot eat wheat, rye or barley - suffer from a previously undetected intestinal bleeding.
Fallacy: A person with celiac sprue (an inherited disorder affecting the lining of the small intestine) may eat small amounts of food containing gluten (a substance found in wheat, rye, barley, and oats) as long as symptoms do not develop.
Celiac disease is also known as celiac sprue, nontropical sprue, and gluten-sensitive enteropathy.
Recurrent partial trisomy 1q22-q44 in clonal intraepithelial lymphocytes in refractory celiac sprue.
The number of people being diagnosed with celiac disease is increasing, and the Celiac Sprue Association has revised its estimates of Americans with celiac disease from one in 10,000 in the 1950s to one in 133 in 2003 to one in 100 in 2010.
They are certified gluten-free by the Celiac Sprue Association and are 100% pork-free.
She founded the non-profit organization, "The National Celiac Sprue Society".