FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2316171301> ?p ?o ?g. }

• W2316171301 endingPage "506" @default.
• W2316171301 startingPage "504" @default.
• W2316171301 abstract "A number of papers have been published supporting the use of serological tests to diagnose celiac disease. IgA antiendomysial antibodies (IgA EmA) have generally been the most accurate. Sensitivities and specificities reported for detecting untreated celiac patients have been 89-100% and 97-100%, respectively (1-4). IgA antibodies to jejunum also hold promise as a highly accurate test for untreated celiac disease (5,6). A review of the literature revealed very few cases of untreated celiac disease missed by IgA EmA, and only two publications reported more than one individual case missed by IgA EmA (1-4,7-16). However, in the past year two consecutive pediatric cases of celiac disease were diagnosed at our medical center by clinical history, physical examination, small bowel biopsy, and subsequent dramatic clinical improvement on a gluten-free diet, yet both had false negative IgA EmA results. CASE REPORTS Patient 1 The patient was a 12-month-old girl admitted for evaluation of failure-to-thrive. She was reportedly healthy with normal development until ≈ 10 months of age when her parents noticed that she became pale, irritable, and less active. Her appetite and weight diminished dramatically. In the 2 months prior to admission, she lost 1.1 kg, dropping from the 25th to <5th percentile for weight. Complete blood count with differential, electrolytes, blood urea nitrogen, creatinine, and urinalysis were all within normal limits. Small bowel biopsy revealed crypt hyperplasia and villus atrophy consistent with celiac disease. IgA EmA and IgA AGA were negative and IgG AGA were positive (Table 1). The patient was placed on a gluten-free diet and exhibited dramatic improvement in appetite, activity, and growth. At 2 years of age she is at the 60th percentile for weight and height, and her development is normal. Patient 2 The patient was a 3½-year-old girl referred to our pediatric gastroenterology clinic for failure-to-thrive. She had poor appetite, vomiting, intermit-tent diarrhea, weight loss, and poor linear growth. She began to cross growth curve lines at ≈ 12 months of age. Four months prior to coming to our clinic, her thyroid-stimulating hormone was elevated, serum T4 was low, and albumin was 3.0. The patient was started on thyroid supplementation. After 4 months of thyroid supplementation her thyroid laboratory tests were normalized, but she had not grown, her albumin was 2.5, her appetite was worse, and she was very irritable. Family history indicated that her maternal grandmother died at age 72 and had had an autoimmune disease that included a goiter and thyroid insufficiency, hemolytic anemia, pernicious anemia, and possible mucocutaneous candidiasis. A maternal uncle also has mucocutaneous candidiasis. The patient's height and weight were at about the 5th percentile for a 2-year-old. We suspected celiac disease, and small bowel histology revealed crypt hyperplasia with villus atrophy. Her serum IgA EmA serology was negative (Table 1). Subsequently, the patient improved rapidly on a glutenfree diet. Four months later she had gained 3.3 kg and had grown 3.7 cm. IgA deficiency has been reported to be associated with celiac disease. Because we were surprised to find negative IgA EmA results in two consecutive patients with celiac disease when IgA EmA testing has been reported to be very sensitive for detecting celiac disease, we tested the serum IgA levels of our patients and found that both patients had IgA deficiency (Table 1). DISCUSSION Selective IgA deficiency is the most common immunodeficiency, occurring in 1:400 to 1:3,080 people (17,18). In these cases, IgA antibodies are abnormally low or totally absent, but IgG synthesis is normal. Many patients with selective IgA deficiency are healthy, but some have respiratory, autoimmune, atopic, oncologic, and/or GI illnesses (19,20). Celiac disease is 10 times more common in patients with IgA deficiency (21). Review of the literature revealed seven cases of IgA deficiency in celiac patients with false-negative IgA EmA results (4,22-24) and five cases of IgA deficiency with false-negative IgA antigliadin antibody results (24,25). Five other patients with active celiac disease and false-negative IgA EmA findings did not have IgA deficiency (9,10). The rate of IgA deficiency among patients with celiac disease has been reported to be 3% (26,27). Based on this rate, the chances of two consecutive celiac patients having IgA deficiency are <1:1,000. We suspect that the rate of IgA deficiency among celiac patients is higher than 3% and that IgA deficiency may account for a sizeable percentage of patients with active celiac disease who have false-negative IgA EmA and false-negative IgA antijejunal antibodies. All patients with active celiac disease and negative IgA EmA results should have serum IgA levels measured, and data should be compiled on the rate of IgA deficiency among celiac disease patients. Although all previous reports have found IgA EmA to be a very sensitive test, we have not found this to be the case because of IgA deficiency in our patients. In patients whose symptoms are likely to be from celiac disease, IgA EmA should not be measured in lieu of small bowel biopsy. If small bowel biopsy is consistent with celiac disease, then IgA EmA should be monitored. Initial IgA EmA positivity and subsequent disappearance of IgA EmA on a gluten-free diet should eliminate the need for repeat small bowel biopsy." @default.
• W2316171301 created "2016-06-24" @default.
• W2316171301 creator A5004055879 @default.
• W2316171301 creator A5007626914 @default.
• W2316171301 date "1996-11-01" @default.
• W2316171301 modified "2023-09-27" @default.
• W2316171301 title "IgA Deficiency Causes False-Negative Endomysial Antibody Results in Celiac Disease" @default.
• W2316171301 cites W1993682019 @default.
• W2316171301 cites W1997742309 @default.
• W2316171301 cites W2000697458 @default.
• W2316171301 cites W2017383716 @default.
• W2316171301 cites W2025972539 @default.
• W2316171301 cites W2026802333 @default.
• W2316171301 cites W2028648452 @default.
• W2316171301 cites W2032306200 @default.
• W2316171301 cites W2033864346 @default.
• W2316171301 cites W2048696834 @default.
• W2316171301 cites W2053586687 @default.
• W2316171301 cites W2057776875 @default.
• W2316171301 cites W2058427584 @default.
• W2316171301 cites W2058702995 @default.
• W2316171301 cites W2059671407 @default.
• W2316171301 cites W206012259 @default.
• W2316171301 cites W2062523260 @default.
• W2316171301 cites W2066932270 @default.
• W2316171301 cites W2078500982 @default.
• W2316171301 cites W2080629354 @default.
• W2316171301 cites W2100379987 @default.
• W2316171301 cites W2103667148 @default.
• W2316171301 cites W2144071099 @default.
• W2316171301 cites W2153751304 @default.
• W2316171301 cites W2326575841 @default.
• W2316171301 doi "https://doi.org/10.1097/00005176-199611000-00029" @default.
• W2316171301 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/8956198" @default.
• W2316171301 hasPublicationYear "1996" @default.
• W2316171301 type Work @default.
• W2316171301 sameAs 2316171301 @default.
• W2316171301 citedByCount "42" @default.
• W2316171301 countsByYear W23161713012012 @default.
• W2316171301 countsByYear W23161713012013 @default.
• W2316171301 countsByYear W23161713012015 @default.
• W2316171301 countsByYear W23161713012016 @default.
• W2316171301 countsByYear W23161713012019 @default.
• W2316171301 countsByYear W23161713012021 @default.
• W2316171301 crossrefType "journal-article" @default.
• W2316171301 hasAuthorship W2316171301A5004055879 @default.
• W2316171301 hasAuthorship W2316171301A5007626914 @default.
• W2316171301 hasBestOaLocation W23161713011 @default.
• W2316171301 hasConcept C126322002 @default.
• W2316171301 hasConcept C159654299 @default.
• W2316171301 hasConcept C203014093 @default.
• W2316171301 hasConcept C2776917539 @default.
• W2316171301 hasConcept C2779102806 @default.
• W2316171301 hasConcept C2779134260 @default.
• W2316171301 hasConcept C2780349322 @default.
• W2316171301 hasConcept C2780898057 @default.
• W2316171301 hasConcept C2993432164 @default.
• W2316171301 hasConcept C3019118998 @default.
• W2316171301 hasConcept C527108885 @default.
• W2316171301 hasConcept C71924100 @default.
• W2316171301 hasConcept C90924648 @default.
• W2316171301 hasConceptScore W2316171301C126322002 @default.
• W2316171301 hasConceptScore W2316171301C159654299 @default.
• W2316171301 hasConceptScore W2316171301C203014093 @default.
• W2316171301 hasConceptScore W2316171301C2776917539 @default.
• W2316171301 hasConceptScore W2316171301C2779102806 @default.
• W2316171301 hasConceptScore W2316171301C2779134260 @default.
• W2316171301 hasConceptScore W2316171301C2780349322 @default.
• W2316171301 hasConceptScore W2316171301C2780898057 @default.
• W2316171301 hasConceptScore W2316171301C2993432164 @default.
• W2316171301 hasConceptScore W2316171301C3019118998 @default.
• W2316171301 hasConceptScore W2316171301C527108885 @default.
• W2316171301 hasConceptScore W2316171301C71924100 @default.
• W2316171301 hasConceptScore W2316171301C90924648 @default.
• W2316171301 hasIssue "4" @default.
• W2316171301 hasLocation W23161713011 @default.
• W2316171301 hasLocation W23161713012 @default.
• W2316171301 hasLocation W23161713013 @default.
• W2316171301 hasOpenAccess W2316171301 @default.
• W2316171301 hasPrimaryLocation W23161713011 @default.
• W2316171301 hasRelatedWork W2033664948 @default.
• W2316171301 hasRelatedWork W2044276960 @default.
• W2316171301 hasRelatedWork W2095079590 @default.
• W2316171301 hasRelatedWork W2144285235 @default.
• W2316171301 hasRelatedWork W2411662263 @default.
• W2316171301 hasRelatedWork W2411946177 @default.
• W2316171301 hasRelatedWork W2471648680 @default.
• W2316171301 hasRelatedWork W3023225023 @default.
• W2316171301 hasRelatedWork W4283161029 @default.
• W2316171301 hasRelatedWork W2898383728 @default.
• W2316171301 hasVolume "23" @default.
• W2316171301 isParatext "false" @default.
• W2316171301 isRetracted "false" @default.
• W2316171301 magId "2316171301" @default.
• W2316171301 workType "article" @default.