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Biomedical subjects

M Vallini

Publications and source records attributed to M Vallini.

8 recordsLinked to original sources
PubMed1996

The coeliac iceberg in Italy. A multicentre antigliadin antibodies screening for coeliac disease in school-age subjects.

BACKGROUND: Recent studies suggest that coeliac disease (CD) is one of the commonest, life-long disorders in Italy. The aims of this multicentre work were: (a) to establish the prevalence of CD on a nationwide basis; and (b) to characterize the CD clinical spectrum in Italy. PATIENTS AND METHODS: Fifteen centres screened 17,201 students aged 6-15 years (68.6% of the eligible population) by the combined determination of serum IgG- and IgA-antigliadin antibody (AGA) test; 1289 (7.5%) were IgG and/or IgA-AGA positive and were recalled for the second-level investigation; 111 of them met the criteria for the intestinal biopsy: IgA-AGA positivity and/or AEA positivity or IgG-AGA positivity plus serum IgA deficiency. RESULTS: Intestinal biopsy was performed on 98 of the 111 subjects. CD was diagnosed in 82 subjects (75 biopsy proven, 7 not biopsied but with associated AGA and AEA positivity). Most of the screening-detected coeliac patients showed low-grade intensity illness often associated with decreased psychophysical well-being. There were two AEA negative cases with associated CD and IgA deficiency. The prevalence of undiagnosed CD was 4.77 x 1000 (95% CI 3.79-5.91), 1 in 210 subjects. The overall prevalence of CD, including known CD cases, was 5.44 x 1000 (95% CI 4.57-6.44), 1 in 184 subjects. The ratio of known to undiagnosed CD cases was 1 in 7. CONCLUSIONS: These findings confirm that, in Italy, CD is one of the most common chronic disorders showing a wide and heterogeneous clinical spectrum. Most CD cases remain undiagnosed unless actively searched.

Adolescent↗
PubMedDate not supplied

[The adolescent celiac].

A group of 81 teenage coeliac patients were recently followed to monitor their compliance with a gluten free diet and also to correlate this with: their general wellbeing, height and weight, antigliadin and antiendomisyal antibody levels and jejunal mucosa patterns. Fifty two patients (64.1%) were on a strict gluten free diet; 18 (22.3%) admitted an occasional gluten intake; 11 (13.6%) were on a normal diet. Symptoms were more frequent in non-compliers that in compliers. There was no appreciable difference between the groups in regard to height and body-mass index, but patients on a normal diet were lighter than the others. Small bowel biopsy was performed on 18 patients with various histological findings. Antigliadin antibodies and antiendomysium antibodies were good indications of a patient's gluten free diet compliance and mucosal damage.

Adolescent↗
PubMedDate not supplied

[Celiac disease and autoimmune thyroiditis. Description of a case].

It has been known that there is a more than fortuitous association between coeliac disease and a whole range of autoimmune conditions. At present there are only very small numbers of cases reported with childhood coeliac disease and thyroiditis. The Authors refer to a seven year old girl with documented coeliac disease who developed an autoimmune thyroiditis with glandular hypofunction, an unusual feature still rarely described.

Celiac Disease↗
PubMedDate not supplied

[Chronic diarrhea due to Cryptosporidium in an immunocompetent subject].

The protozoan Cryptosporidium has been described in many cases of acute self-limiting diarrhoea in immunocompetent patients and of more protracted or life threatening diarrhoea in immunocompromised patients. We found the parasite in the stools of a child with chronic diarrhoea and without deficiency of immunity. The test for common causes of chronic diarrhoea were normal. The end of the clinical manifestation and the normalization of the test to identify Cryptosporidium in the stools, after a specific therapy, prove the presence of a casual relation between the patient's symptomatology and the finding of the protozoan in his stools.

Animals↗
PubMedDate not supplied

[Sideropenic anemia and celiac disease].

Since the beginning of the use of Antigliadin Antibodies (AGA) in the screening of coeliac disease (CD) we have observed an increasing in the total number of cases diagnosed, in particular of the cases with monosymptomatic and atypical forms. Iron deficiency anemia is one of the more frequent findings that we can find in CD, either in association with other typical coeliac signs, or as an isolated expression of the disease. The first aim of our study was to determine the incidence of iron deficiency anemia in our patients affected by CD at the moment of diagnosis. The second aim was to determine the incidence of CD in a group of 96 patients attending our Pediatric Hematology department for iron deficiency anemia of unknown etiology and refractory to iron therapy. 103 patients out of our 212 coeliacs (48.5%) showed hypochromic and microcytic anemia. In the second sample we found 6 (6.2%) patients, positive in AGA and Antiendomysium Antibodies (AEA), that showed a typical coeliac picture at the jejunal biopsy. Our study confirms the high incidence of iron deficiency anemia in patients affected by coeliac disease. However the most important conclusion of our study is that a certain percentage of patients affected by hypochromic anemia of unknown etiology may be affected by coeliac disease. It is only by performing the specific screening tests (AGA and AEA) in the patients affected by iron deficiency anemia of unknown etiology, that we can diagnose this monosymptomatic expression of CD.

Adolescent↗
PubMedDate not supplied

[Discordance in the onset of celiac disease in monozygotic twins].

Coeliac disease (CD) is a gluten intolerance caused by a combination of genetic and environmental factors such as nutrition and infections. Monozygotic twins appear to have a concordance for CD up to 71%. This paper reports a third case of late onset of CD in monozygotic twin girls. The twins were defined as monozygotic based upon paired clinical and laboratory examinations. Clinical examinations included genotypic, phenotypic and dermatoglyphic analysis, while laboratory examinations included HLA typing and blood groups. Following European Society of Pediatric Gastroenterology and Nutrition criteria, CD was diagnosed in both girls, though 4 years and 8/12 months apart. The twins achieved clinical, laboratory and histological remissions within 1 year, after the institution of a gluten-free diet. Genetic markers are undoubtedly the main precondition for CD development. Environmental factors, however, may play a more significant role in triggering the onset of disease.

Celiac Disease↗
PubMedDate not supplied

[Celiac disease in children with Down's syndrome].

The coexistence of Down's syndrome (DS) and coeliac disease (CD) has been occasionally reported and both diseases are often related to autoimmune disorders. The pathogenetic factor that links CD and DS may be an altered immune system and/or the presence of a common genetic factor. Some epidemiological investigations, performed in patients with CD, showed an increased incidence of DS compared to the natural incidence of this abnormality in the general population. We studied the prevalence of CD in 83 individuals with DS compared to a group of 200 patients with other gastroenterologic disorders and a random scholastic sample of 500 non symptomatic children. IgG and IgA antigliadin antibodies (AGA) were determined in all patients. Antiendomysium antibodies (EmA) were investigated in all the patients of the first group, while in the other two groups, 27 and 108 cases respectively, selected by AGA positivity, were investigated for EmA. The percentage of AGA IgA positivity in the first group was 31.3% (26/83), in gastroenterologic controls 10% (20/200), in scholastic sample 2.8% (14/500), that shows a significant statistical difference. On the contrary EmA were positive in quite a similar percentage in the three groups. Duodenal [correction of Jejunal] biopsies, were performed in 11 DS patients and in 9 of the other two groups. EmA were positive only in the case with subtotal atrophy in all the groups: 5/11 in the first, 2/4 in the second, 2/5 in the third. On the contrary AGA IgA were often positive also in patients with non coeliac histologic findings.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗