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- W2218674331 abstract "Emanuel B, Lieberman AD. J Pediatr 1963;62:435-7 This is a case report of a 2-year-old child with diarrhea and failure to thrive who had neurologic and behavioral symptoms. An abnormal electroencephalographic pattern was noted. Based on tests for malabsorption, a clinical diagnosis of celiac disease was made. Gluten-free diet led to significant improvement in symptoms and normalization of the electroencephalographic abnormalities. The authors concluded that there was evidence of an organic or neurophysiologic basis for the abnormal behavior and neurodevelopmental delay of this patient with celiac disease. Since 1963, major advances have occurred in celiac disease including a better understanding of its pathogenesis, recognition of the variability in clinical presentations, and an improved ability in making a timely diagnosis especially with the use of screening serologic tests (such as anti-endomysial and anti-tissue transglutaminase antibodies). Once considered to be a rare malabsorptive disorder of infancy and early childhood, celiac disease is now known to be a common, multi-system, autoimmune disorder affecting 1% of the population.1Fasano A. Surprises from celiac disease.Scientific American. 2009;Aug; (Available at): 32-39www.ScientificAmerican.comGoogle Scholar Patients with celiac disease can present with either intestinal or extra-intestinal manifestations. Some of the neurologic and psychologic disturbances include peripheral neuropathy, ataxia, epilepsy with intracranial calcifications, depression, and migraine headaches. The precise role of gluten in the causation of these symptoms is still under investigation. Interestingly, despite limited understanding of pathophysiological mechanisms, the authors of the case report made the astute observation that neurologic symptoms were present in celiac disease and not cystic fibrosis (although both disorders cause steatorrhea). Gluten was, thus, suspected to be the primary cause of the neurobehavioral dysfunction. Unfortunately, the final diagnosis of celiac disease in the child described in the case report was established only on autopsy. Today, fiberoptic endoscopy is the primary procedure for obtaining small intestinal biopsies to confirm the diagnosis by histopathology while on a regular (gluten-containing) diet. Glucose tolerance testing and barium roentgen studies are no longer used to investigate malabsorption. Magnetic resonance imaging and positron emission tomography scan can better define the structure and function of the brain. The cause of death in the case report was not mentioned. However, with advances in management, mortality in children with celiac disease these days is most unusual." @default.
- W2218674331 created "2016-06-24" @default.
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- W2218674331 date "2013-03-01" @default.
- W2218674331 modified "2023-10-16" @default.
- W2218674331 title "50 Years Ago in The Journal of Pediatrics" @default.
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- W2218674331 doi "https://doi.org/10.1016/j.jpeds.2012.09.043" @default.
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