Auteur Topic: Volledig artikel (pdf) Celiac Disease: The Endocrine Connection  (gelezen 1530 keer)

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Volledig artikel (pdf) Celiac Disease: The Endocrine Connection
« Gepost op: juli 13, 2010, 18:35:08 »
Volledig artikel (pdf) - 3 pagina's.

Citaat
Volume 25, Issue 4, Pages 311-313 (August 2010)

Celiac Disease: The Endocrine Connection

Een paar stukjes uit dit artikel:
Silent CD refers to individuals who are asymptomatic but have positive celiac antibodies and small bowel biopsies consistent with CD (Fasano, 2005).

These children are often diagnosed because they have an existing condition that is associated with an increased risk of developing CD and were screened for CD.
Conditions that share a genetic association with CD are Down syndrome, Turner syndrome, Williams syndrome, and selective IgA deficiency (Green and Cellier, 2007, Hill et al., 2005, NIH Consensus Development Panel, 2004).
Strong evidence suggests the increased prevalence of CD in children with Down syndrome is between 5% and 12% (Hill et al., 2005).
First- and second-degree relatives of those with CD are also at increased risk of developing CD. Fasano et al. (2003) documented that the prevalence of CD in asymptomatic relatives was as high as that in symptomatic relatives.
Autoimmune diseases associated with a higher incidence of CD are Type 1 diabetes and autoimmune thyroiditis (Green and Cellier, 2007, Hill et al., 2005, NIH Consensus Development Panel, 2004).
Routine screening for CD is recommended for those who have gastrointestinal symptoms, dermatitis herpetiformis (an extremely itchy rash with bumps and blisters), and unexplained non-gastrointestinal symptoms, such as growth failure, short stature, and delayed puberty (Fasano et al., 2008, NIH Consensus Development Panel, 2004).
In addition, anyone with a positive family history for CD or a condition associated with a higher incidence of CD should be routinely screened (Fasano et al., 2008, NIH Consensus Development Panel, 2004).

The Endocrine Association With CD
It is essential for pediatric endocrine nurses to have a working knowledge of CD because there are several clinical presentations that should include CD as part of the differential diagnosis.
There is an increased prevalence of CD in children with short stature; 8%10% of children with idiopathic short stature had positive CD serologic screening (Catassi and Fasano, 2008, Hill et al., 2005).
In addition, Catassi & Fasano (2008) report that CD is more common than growth hormone deficiency in children being evaluated for short stature. They describe alterations in IGF-1 in young children and IGF-BP3 in older children that improve with implementation of a gluten-free diet (GFD).

Zinc deficiency and low response of GH secretion may also play a role in CD-associated short stature.
Once the GFD is initiated, there is a marked increase in growth velocity, although catchup growth may not be complete (Catassi & Fasano, 2008).

Similarly, adolescent females with untreated CD may have delayed onset of menarche (Catassi and Fasano, 2008, Hill et al., 2005).
In adulthood, these women may also experience amenorrhea, early menopause, recurrent abortions, and infertility (Catassi & Fasano, 2008). Malnutrition as a result of undiagnosed CD is thought to play a role in gynecological disorders (Catassi & Fasano, 2008).
Infertility is an issue for both men and women (Catassi & Fasano, 2008).

Although the association between autoimmune thyroiditis and CD is low in children, it is higher in adults (Hill et al., 2005).
Link van dit artikel:
http://download.journals.elsevierhealth.com/pdfs/journals/0882-5963/PIIS0882596310001284.pdf

Schrijfster van dit artikel:
Marianne Buzby, RN, MSN, CRNP
Advanced Senior Lecturer B
University of Pennsylvania School of Nursing




Groeten, Ine