A woman with a 10 year history of abdominal pain

Preliminary studies also suggest a strong association between the use of drugs that suppress gastric acid secretion, such as proton pump inhibitors, with a subsequent diagnosis of coeliac disease. 2 The pathogenesis differs from immediate IgE controlled hypersensitivity reactions.The gluten protein...

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Bibliographic Details
Published in:BMJ (Online) 2018-03, Vol.360, p.k603-k603
Main Authors: Richelieu, Jessica, Morse, John WI, Pfeiffer, David C
Format: Article
Language:English
Subjects:
Abdomen
Antibiotics
Cancer therapies
Celiac disease
Colonoscopy
Colorectal cancer
Crohn's disease
Diagnostic tests
Diet
Gastroenterology
Giardia lamblia
Gluten
Helicobacter pylori
Hypersensitivity
Liver diseases
Pain
Patients
Proton pump inhibitors
Small intestine
Ulcers
Womens health
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Summary:Preliminary studies also suggest a strong association between the use of drugs that suppress gastric acid secretion, such as proton pump inhibitors, with a subsequent diagnosis of coeliac disease. 2 The pathogenesis differs from immediate IgE controlled hypersensitivity reactions.The gluten protein is activated by tissue tTG, and gluten tTG complexes are presented to CD4 T cells found in the lamina propria of the small intestine, resulting in the generation of autoantibodies against tTG. 3 Clinical features can present in childhood or adulthood.[...]it is now known that these changes can also be seen with drug overuse, other immunodeficiency, and infection with organisms such as Giardia lamblia or Helicobacter pylori.[...]biopsies often must be confirmed with serology, and follow-up biopsies should be taken after restriction of gluten to determine efficacy. 4 Serology testing uses detection of IgA anti-tissue tTGA by enzyme linked immunosorbent assay.
ISSN:0959-8138
1756-1833
DOI:10.1136/bmj.k603