genetic study of celiac disease in patients with multiple sclerosis in comparison with celiac patients and healthy controls

Background: Studies have reported the controversial association between multiple sclerosis [MS] and celiac disease [CD]. Thus, we aimed to conduct a case control study on patients with MS, CD, and controls to investigate CD in patients with MS by means of comparing CD genetic markers in patients with MS and controls. We also evaluated serological markers in patients with MS

Materials and Methods: This is a case control study conducted on 60 patients with MS, 140 patients with CD, and 151 healthy controls in 2015 in Tehran, Iran. HLA typing was done to identify the carriers of the DQB1*02, DQB1*0301, DQA1*05, or DQA1*0201 alleles for HLA-DQ2, DQB1*0302, or DQA1*03 for HLA-DQ8. All data were analyzed using SPSS software [version 23, IBM Corp]. Serological markers including anti-gliadin antibodies [AGA] [IgA, IgG], anti-tissue trans glutaminase antibodies [Anti tTG] [IgA, IgG], anti-endomysial antibody [EMA] [IgA, IgG], and total IgA were assessed in MS group by enzyme immunoassays

Results: The data of 60 patients with MS [26.7% male, mean age = 34.83 years], 140 patients with CD [33.6% male, mean age = 38.37 years] and 151 controls [48.3% male, mean age = 40.43 years] were analyzed. The results of serological markers were not positive in any of the patients with MS. The prevalence of IgA deficiency [IgA

Conclusion: Our results did not show any correlation between MS and CD, which was similar to other studies

Celiac disease in patients with neuropathy

Background: Neuropathy means nerve damage, which interferes with the functioning of the peripheral nervous system. It has been mentioned as one of the extra-intestinal manifestations of celiac disease. This study aimed to investigate the prevalence of celiac disease in patients presented with idiopathic neuropathy

Materials and Methods: A cross-sectional study was done in patients with idiopathic neuropathy at Shariati Hospital, Tehran. Serological tests including endomysial IgA, tissue transglutaminase [TTG] IgA and IgG, and DGP[deamidated gliadin peptide] IgA, and genetic assessment for HLA DQ2 and DQ8[human leukocyte antigen] were done for all patients and those who had positive celiac serology and HLA DQ2/DQ8 underwent endoscopy and adequate biopsy samples were taken. Diagnosis was made based on histopathological report of celiac disease

Results: 101 patients with idiopathic neuropathy were enrolled. The mean age was 43.56+/-10.66 years [range 70-18 years]. The prevalence of HLA-DQ2 and HLA-DQ8 positivity in patients with idiopathic neuropathy was 36.6% and 9.9%, respectively. The most common neuropathy subtype in patients with positive HLA-DQ2 and DQ8 was demyelinating PN[peripheral neuritis]. One patient [1%] was diagnosed as havine celiac disease

Conclusion: Although the prevalence of celiac disease in patients with idiopathic neuropathy was similar to the general population, having considered the pravalence of celiac disease, treating this condition with gluten-free diet is of importance

Pathological and clinical correlation between celiac disease and pathological and clinical correlation between celiac disease andpathological and clinical correlation between celiac disease and helicobacter pylori infection; a review of controversial rep

There are overwhelming reports and descriptions about celiac associated disorders. Although there is a clear genetic association between celiac disease [CD] and some gastrointestinal disorders, there are controversial reports claiming an association between CD and Helicobacter pylori [H. pylori] infection. Different studies indicated the possible association between lymphocytic gastritis and both CD and H. pylori infection, although this evidence is not consistently accepted. Also it was shown that an increase in intraepithelial lymphocytes count is associated with both H. pylori infection and celiac disease. Therefore the following questions may raise: how far is this infection actually related to CD?, which are the underlying patho-mechanisms for these associations? what are the clinical implications? what is the management? and what would be the role of gluten free diet in treating these conditions? PubMed [PubMed Central], Ovid, ISI of web knowledge, and Google scholar were searched for full text articles published between 1985 and 2015. The associated keywords were used, and papers described particularly the impact of pathological and clinical correlation between CD and H. pylori infection were identified. In this review we tried to answer the above questions and discussed some of the recent developments in the pathological and clinical aspects of CD and H. pylori infection

likelihood ratio and frequency of DQ2/DQ8 haplotypes in Iranian patients with celiac disease

Aim: The aim of this study was to evaluate the likelihood ratio and frequency of DQ2 and DQ8 in Iranian patients with celiac disease [CD]

Background: The HLA DQ2 and HLA DQ8 are the important mediators in the development of celiac disease. A few studies evaluated the frequency of HLA DQ2 and HLA DQ8 haplotypes among the Iranian population with low sample size

Patients and methods: In this cross-sectional study, to predict HLA-DQ2 and DQ8 haplotypes, 141[73 male, 78 female] confirmed CD patients compared to 151 healthy controls were enrolled into this study during 2013-2014. HLA DQ2/ DQ8 haplotypes was determined in cases and controls using PCR-SSP technique

Results: DQ2 and DQ8 were positive in 80% [n=111] and 49% [n= 69] of CD patients and 36% [n=61] and 13% [n=21] of control group respectively. Moreover, 32% [n=45] of CD patients and 5.3% [n=8] of the control group were carrier of both haplotypes. In the case group about one-third of patients [32.2%] were positive for carrying both DQ2 and DQ8 heterodimers while only 5.3% [n=8] of the control group were carrier. In addition, the positive likelihood ratio of DQ2 and DQ8 were 1.74 [CI: 1.4- 2.1], and 2.6 [CI: 1.8- 2.7], respectively

Conclusion: The result of this study showed that the frequency of DQ8 among our population is higher than those reported by European countries, but it is close to those founded in South America and Middle East. This result suggests that the higher prevalence of HLA DQ8 pattern in Iranian CD patients is similar to non-European patients

Is it necessary to screen for celiac disease in adult idiopathic osteoporosis?

The aim of this study was to investigate the necessity of screening for celiac disease in idiopathic osteoporotic patients. Osteopenia and osteoporosis are well-known and prevalent complications of celiac disease. However, the relative prevalence of celiac disease among osteoporotic populations is not known, and the benefit of screening for celiac disease among the osteoporotic population remains controversial. We evaluated a total of 560 individuals, 460 with osteoporosis and 100 healthy subjects, from the rheumatology clinic in Imam Khomeini and Shariati hospital by IgA anti-tissue transglutaminase [anti-tTG] for celiac disease. Then individuals with positive serologic test underwent upper GI Endoscopy and 2nd part duodenum biopsies. The clinical findings were evaluated in both groups and were compared with each other. Five [1.08%] of 460 patients with osteoporosis and 1 [1%] of 100 subjects without osteoporosis had celiac disease by positive serologic and pathology results. Three patients with positive serology and pathology results were female. All patients in osteoporotic group had at least one other symptom of celiac disease. Two of them had anemia and others had chronic abdominal pain, recurrent oral aphtous lesion and chronic bloating. In the present study, the prevalence of celiac disease in osteoporotic patients is not high enough to justify recommendation for serologic screening of celiac disease in all patients with idiopathic osteoporosis; but in osteoporotic patients with other celiac or gastrointestinal symptoms and signs, for example iron deficiency anemia, chronic dyspepsia and bloating, constipation or diarrhea and recurrent aphtous lesions, it is necessary to evaluate for celiac disease

Mean polyp per patient is an accurate and readily obtainable surrogate for adenoma detection rate: results from an opportunistic screening colonoscopy program

The incidence of colorectal cancer is rising in several developing countries. In the absence of integrated endoscopy and pathology databases, adenoma detection rate [ADR], as a validated quality indicator of screening colonoscopy, is generally difficult to obtain in practice. We aimed to measure the correlation of polyp-related indicators with ADR in order to identify the most accurate surrogate [s] of ADR in routine practice. We retrospectively reviewed the endoscopic and histopathological findings of patients who underwent colonoscopy at a tertiary gastrointestinal clinic. The overall ADR and advanced-ADR were calculated using patient-level data. The Pearson's correlation coefficient [r] was applied to measure the strength of the correlation between the quality metrics obtained by endoscopists. A total of 713 asymptomatic adults aged 50 and older who underwent their first-time screening colonoscopy were included in this study. The ADR and advanced-ADR were 33.00% [95% CI: 29.52-36.54] and 13.18% [95% CI: 10.79-15.90], respectively. We observed good correlations between polyp detection rate [PDR] and ADR [r=0.93], and mean number of polyp per patient [MPP] and ADR [r=0.88] throughout the colon. There was a positive, yet insignificant correlation between advanced ADRs and non-advanced ADRs [r=0.42,p=0.35]. MPP is strongly correlated with ADR, and can be considered as a reliable and readily obtainable proxy for ADR in opportunistic screening colonoscopy programs

Characteristics of colorectal polyps and cancer; a retrospective review of colonoscopy data in Iran

Early diagnosis and endoscopic resection of adenomatous polyps is the main approach for screening and prevention of colorectal cancer [CRC]. We aimed to assess polyp detection rate [PDR] and to characterize demographic, clinical, and pathological features of colorectal polyps in an Iranian population. We retrospectively analyzed the data from 5427 colonoscopies performed during 2007-2012 at Masoud Clinic, the main endoscopy center associated with Sasan Alborz Biomedical Research Center, in Tehran, Iran. Our sample included 2928 [54%] women and 2499 [46%] men, with the mean age of 48.3 years [SD=16.1]. The most common reasons for colonoscopy included screening in 25.0%, and gastrointestinal bleeding in 15.2%. Cecal intubation was successful in 86% of patients. The quality of bowel preparation was fair to excellent in 78.1% [n=4235] of colonoscopies. Overall PDR was 42.0% [95% CI: 40.6-43.3]. The PDR in men [51.1%, 95% CI: 49.1-53.1] was significantly higher than women [34.2%, 95% CI: 32.4-35.9, p<0.001]. Polyps were more frequently observed in patients after the 6th decade of life [F=3.2; p=0.004]. CRC was detected in 2.9% [73/2499] of men and 1.9% [57/2928] of women [p=0.02]. The mean age for patients with cancer was significantly higher than that for individuals with polyps, 60.9 [SD=13.4] year vs. 56.9 [SD=13.7] year, respectively [p=0.001]. Almost 82.8% of the lesions were precancerous with tubular type predominance [62.3%] followed by tubulo-villous [10.3%], villous [6.6%], and serrated [3.6%]. Hyperplastic/inflammatory polyps comprised 17.2% of lesions. Distal colon was more prone to develop polyps and cancer than proximal colon in our series. These findings provide a great infrastructure for next preventive programs and have implications for colorectal cancer screening at population-level