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==Celiac sprue== | ==Celiac sprue== | ||
{{main|Duodenum}} | |||
===General=== | ===General=== | ||
*Etiology: autoimmune. | |||
====Epidemiology==== | ====Epidemiology==== | ||
*Associated with: | *Associated with: | ||
**The skin condition ''[[dermatitis herpetiformis]]''.<ref>TN 2007 D22</ref> | **The skin condition ''[[dermatitis herpetiformis]]''.<ref>TN 2007 D22</ref> | ||
**IgA deficiency - 10-15X more common in celiac disease vs. healthy controls.<ref name=pmid12414763>{{Cite journal | last1 = Kumar | first1 = V. | last2 = Jarzabek-Chorzelska | first2 = M. | last3 = Sulej | first3 = J. | last4 = Karnewska | first4 = K. | last5 = Farrell | first5 = T. | last6 = Jablonska | first6 = S. | title = Celiac disease and immunoglobulin a deficiency: how effective are the serological methods of diagnosis? | journal = Clin Diagn Lab Immunol | volume = 9 | issue = 6 | pages = 1295-300 | month = Nov | year = 2002 | doi = | PMID = 12414763 }}</ref> | **IgA deficiency - 10-15X more common in celiac disease vs. healthy controls.<ref name=pmid12414763>{{Cite journal | last1 = Kumar | first1 = V. | last2 = Jarzabek-Chorzelska | first2 = M. | last3 = Sulej | first3 = J. | last4 = Karnewska | first4 = K. | last5 = Farrell | first5 = T. | last6 = Jablonska | first6 = S. | title = Celiac disease and immunoglobulin a deficiency: how effective are the serological methods of diagnosis? | journal = Clin Diagn Lab Immunol | volume = 9 | issue = 6 | pages = 1295-300 | month = Nov | year = 2002 | doi = | PMID = 12414763 }}</ref> | ||
**Risk factor for ''gastrointestinal T cell lymphoma'' - known as: ''enteropathy-associated T cell lymphoma'' (EATL). | **Risk factor for ''gastrointestinal T cell lymphoma'' - known as: ''enteropathy-associated T cell lymphoma'' (EATL). | ||
==== | ====Clinical==== | ||
Treatment: | |||
*Gluten free diet. | *Gluten free diet. | ||
**''Mnemonic'': BROW = barley, rye, oats, wheat. | **''Mnemonic'': BROW = barley, rye, oats, wheat. | ||
Serologic testing: | |||
*Anti-transglutaminase antibody. | *Anti-transglutaminase antibody. | ||
**Alternative test: anti-endomysial antibody. | **Alternative test: anti-endomysial antibody. | ||
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*If you see acute inflammatory cells, i.e. neutrophils, consider Giardiasis and other infectious etiologies. | *If you see acute inflammatory cells, i.e. neutrophils, consider Giardiasis and other infectious etiologies. | ||
*Biopsy should consist of 2-3 sites. In children it is important to sample the duodenal cap, as it is the only affected site in ~10% of cases. | *Biopsy should consist of 2-3 sites. In children it is important to sample the duodenal cap, as it is the only affected site in ~10% of cases. | ||
===Grading=== | ===Grading=== | ||
Rarely done - see ''[[celiac disease]]'' article. | |||
==Giardiasis== | ==Giardiasis== |
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