Talk:Coeliac disease/Archive 1

message: I am a gastroenteorlogist with an interest in this disease.
I am going to be proposing and executing some major edits.  The science on this has advanced quite a bit. This is a disease of major interest, and has an element of patient activism due to the disease being underdiagnosed up until recently (still a problem) For folks that have interests in suggesting topics to include, please post in the discussions.
Stephen Holland, M.D.
Kd4ttc
:I agree with you, Stephen (kd4ttc)!  There a lot of disease articles that need major rewrites... Hfwd 00:47, 7 Dec 2004 (UTC)
thread_title:  Greetings 

message: I think the religious controversy section is a bit over the top and imbalances the article. Dokane 16:48, 6 Oct 2004 (UTC)
replies: text: Well done. JFW | T@lk 10:43, 10 Oct 2004 (UTC)

text: The section of Communion should be moved to Communion and the section on Passover moved there.  Kd4ttc 21:22, 8 January 2006 (UTC)
thread_title:  Religious controversy section 

message: From what I have read there is research going on about a possible medication that can allow celiacs to eat regular food. Maybe a section on research and medication should be added? There is an article covering one possible medication at the following address:
http://www.nature.com/ncpgasthep/journal/v2/n3/full/ncpgasthep0111.html
Madman332 13 Jan 2006 (UTC)
If anything I would add that it will be a bad idea.  Immunology works at very low antigen concentrations.  However, that would look like original research.  I don't mind my saying it since I do GI.  If you want to mention the article go ahead and I'll follow up with something.  Steve  Kd4ttc 18:18, 13 January 2006 (UTC)
thread_title:  Add a research section? 

message: I'm a 'coeliac' myself, and of necessity an autodidact on the matter.  For some time I squandered vast amounts of time trying to educate beer-drinking celiacs about their gullibility when it came to hearsay 'information' about certain beers -- Uncle Fred said Guinness was gluten-free, for example, and his word was taken at face value.  I finally gave up: they wanted to believe, and they persisted in their belief.
This is not the same as the wafer issue, but in both cases, desires and beliefs drive actions.
Roger Scrafford
:Some coeliacs are cross-sensitive to secaleins and hordeins, which may occur in beer. If these people are not getting malabsorption symptoms they may be fine, but a surveillance biopsy may reveal the harsh truth :-( JFW | T@lk 13:50, 2 Dec 2004 (UTC)
thread_title:  Beer 

message: On 15 Jan I created a link to http://www.msnbc.msn.com/id/5762478/, as it provides an example of the controversy surrounding this disease and the Catholic church.  The addition was immediately deleted, but there was no reason given.  Is a link of this nature inappropriate?  Was the link too NPOV?  If so, I'll try to find a better example, but I truly believe that linking to a story that details both sides helps readers gain contextual understanding. 67.171.64.84 18:51, 15 Mar 2005 (UTC)
replies: text: Perhaps you should put it back as a footnote. If it is inserted as an external link, it would clutter the article. JFW | T@lk 06:38, 16 Mar 2005 (UTC)
thread_title:  External link 

message: I just wanted to thank all the people who have worked hard on this article, as i am also suffering from the disease. i just recently discovered this issue (1 month or so ago) and it is hard to deal with. i really want some pizza, but i cant. thanks again, Gazeofsorrow 06:06, 21 Apr 2005 (UTC)
thread_title:  Thanks 

message: I have celiac, too (diagnosed ca. 5 years ago), and although at first I was quite depressed about it and often yearned for my favorite food (same as you - pizza), I eventually found that celiac was actually a blessing. It forced me to try different foods and ultimately enriched my diet. Now I cook all kinds of different foods - Indian, Korean, Chinese, etc., and I've grown to accept and actually be proud of my condition. It may seem paradoxical, but strangely, celiac actually gives us more options.
P.S. Regarding pizza, there are a number of good gluten-free pizza mixes. The best one is by The Gluten-Free Pantry (www.glutenfree.com) and it is called the "Country French Bread and Pizza Mix". Even non-celiacs I know like it.
--149.159.2.14 19:18, 10 August 2005 (UTC)
thread_title:  re:"thanks"   GF pizza 

message: At first I want to express that I find this article on coeliac disease pretty good. Thanks for the work altogether!
I added the hint to Gramineae in the therapy section. That's a conclusion from self-described case studies i received and experiments not only by myself but by some other people too who didn't recover from a gluten-free diet alone. One toxicologist and one physician were among the people. Partial blood analysises and allergy tests were included. The problem with coeliac disease is (in some cases) probably not only a problem of defective gluten digestion and according T-cell mediated immune response but related to prolamines of the Gramineae family of plants in general. Allergic responses to Gramineae challenging support this opinion in some cases of suspected (but neither definitely proven nor ruled out by biopsy and antibody testing) coeliac disease.
For those having trouble even with gluten-free beer: Beer contains hops. And hops also is a member of the Gramineae family...
For those possibly affected by the disease and searching for literatur on the lesser well-known symptoms of c.d. I give here some references for further reading. (Unfortunately Wikipedia articles do not have a special section for literature what bothers me for years now.) In chronological order:
* Morris, J.S.; Adjukiewicz, A.B. & Read, A.E. Coeliac infertility: an indication for dietary gluten restriction? Lancet, 1970, 1, 213-
* Green, J.R.; Goble, H.L.; Edwards, C.R. & Dawson, A.M. Reversible insensitivity to androgens in men with untreated gluten enteropathy. Lancet, 1977, 1, 280-2
* Vanderschueren-Lodeweyckx, M.; Eggermont, E.; Cornette, C.; Malvaux, P.; Eeckels, R. & Beckers, C. [TSH-response to TRH in active coeliac disease in infants (author's transl)] Ann Endocrinol (Paris), 1978, 39, 149-50
* Prader, A. [Normal growth and disorders of growth in children and adolescents (author's transl)] Klin Wochenschr, 1981, 59, 977-84
* Farthing, M.J.; Edwards, C.R.; Rees, L.H. & Dawson, A.M. Male gonadal function in coeliac disease: 1. Sexual dysfunction, infertility, and semen quality. Gut, 1982, 23, 608-14
* Farthing, M.J.; Mattei, A.M.; Edwards, C.R. & Dawson, A.M. Relationship between plasma testosterone and dihydrotestosterone concentrations and male facial hair growth. Br J Dermatol, 1982, 107, 559-64
* Farthing, M.J.; Rees, L.H. & Dawson, A.M. Male gonadal function in coeliac disease: III. Pituitary regulation. Clin Endocrinol (Oxf), 1983, 19, 661-71
* Farthing, M.J.; Rees, L.H.; Edwards, C.R. & Dawson, A.M. Male gonadal function in coeliac disease: 2. Sex hormones. Gut, 1983, 24, 127-35
* Magazzu, G.; Luca, F.d.; Benvenga, S. & Trimarchi, F. [Transient biological hypothyroidism in an infant carrier of celiac disease] Pediatrie, 1983, 38, 249-52
* Várkonyi, A. & Falkay, G. [Hyperprolactinemia in children with celiac disease] Monatsschr Kinderheilkd, 1984, 132, 547-9
* Korepanov, A.M. & Ivanov, G.I. [Several endocrine aspects of duodenal stasis in the process of therapeutic gymnastics] Ter Arkh, 1987, 59, 65-8
* Ventura, A.; Florean, P.; Trevisan, M.; Not, T.; Perticarari, S.; Quadrifoglio, F.; Torre, G. & Cauci, S. [Anti-alpha-gliadin antibodies. Sensitivity, specificity and correlation with blood xylose test in the 3 diagnostic stages of celiac disease in children] Pediatr Med Chir, 1987, 9, 653-60
* Zadik, Z. & Kowarski, A. Incidence of neurosecretory dysfunction among children aged 6-14 years in Rehovot, Israel. Acta Paediatr Scand Suppl, 1989, 349, 77-80; discussion 81-3
* Sher, K.S.; Jayanthi, V.; Probert, C.S.; Stewart, C.R. & Mayberry, J.F. Infertility, obstetric and gynaecological problems in coeliac sprue. Dig Dis, 1994, 12, 186-90
* Hoggan, R. Considering wheat, rye, and barley proteins as aids to carcinogens. Med Hypotheses, 1997, 49, 285-8
* Reifen, R.; Buskila, D.; Maislos, M.; Press, J. & Lerner, A. Serum prolactin in coeliac disease: a marker for disease activity. Arch Dis Child, 1997, 77, 155-7
* Várkonyi, A.; Boda, M.; Endreffy, E.; Németh, I. & Timár, E. Coeliac disease: always something to discover. Scand J Gastroenterol Suppl, 1998, 228, 122-9
* Collin, P.; Hakanen, M.; Salmi, J.; Mäki, M. & Kaukinen, K. Autoimmune hypopituitarism in patients with coeliac disease: symptoms confusingly similar. Scand J Gastroenterol, 2001, 36, 558-60
* James, W.H. Hormones and offspring sex ratios associated with celiac disease. Am J Gastroenterol, 2001, 96, 2266-7
* Johnson, T.N.; Tanner, M.S.; Taylor, C.J. & Tucker, G.T. Enterocytic CYP3A4 in a paediatric population: developmental changes and the effect of coeliac disease and cystic fibrosis. Br J Clin Pharmacol, 2001, 51, 451-60
* Blanco Quirós, A.; Arranz Sanz, E.; Garrote Adrados, J.A.; Oyágüez Ugidos, P.; Calvo Romero, C. & Alonso Franch, M. [The tumor necrosis factor system and leptin in coeliac disease] An Esp Pediatr, 2001, 55, 198-204
* Dunger, D.; Ahmed, L. & Ong, K. Growth and body composition in type 1 diabetes mellitus. Horm Res, 2002, 58 Suppl 1, 66-71
* Porpora, M.G.; Picarelli, A.; Porta, R.P.; Tola, M.D.; D'Elia, C. & Cosmi, E.V. Celiac disease as a cause of chronic pelvic pain, dysmenorrhea, and deep dyspareunia Obstetrics & Gynecology, 2002, 99, 937-939
* Bernstein, C.N. & Leslie, W.D. The pathophysiology of bone disease in gastrointestinal disease. Eur J Gastroenterol Hepatol, 2003, 15, 857-64
* Green, P.H.R. & Jabri, B. Coeliac disease. Lancet, 2003, 362, 383-91
* Jansson, U.H.G.; Kristiansson, B.; Albertsson-Wikland, K. & Bjarnason, R. Short-term gluten challenge in children with coeliac disease does not impair spontaneous growth hormone secretion. J Pediatr Endocrinol Metab, 2003, 16, 771-8
* Bozzola, M.; Giovenale, D.; Bozzola, E.; Meazza, C.; Martinetti, M.; Tinelli, C. & Corazza, G.R. Growth hormone deficiency and coeliac disease: an unusual association? Clin Endocrinol (Oxf), 2005, 62, 372-
* Capristo, E.; Farnetti, S.; Mingrone, G.; Certo, M.; Greco, A.V.; Addolorato, G. & Gasbarrini, G. Reduced plasma ghrelin concentration in celiac disease after gluten-free diet treatment. Scand J Gastroenterol, 2005, 40, 430-6
* Karagiannis, A. & Harsoulis, F. Gonadal dysfunction in systemic diseases. Eur J Endocrinol, 2005, 152, 501-13
* Peters, J.H.; McKay, B.M.; Simasko, S.M. & Ritter, R.C. Leptin-induced satiation mediated by abdominal vagal afferents. Am J Physiol Regul Integr Comp Physiol, 2005, 288, R879-84
* Pynnönen, P.A.; Isometsä, E.T.; Verkasalo, M.A.; Kähkönen, S.A.; Sipilä, I.; Savilahti, E. & Aalberg, V.A. Gluten-free diet may alleviate depressive and behavioural symptoms in adolescents with coeliac disease: a prospective follow-up case-series study. BMC Psychiatry, 2005, 5, 14
They are mostly related to disturbances of the endocrine system because that is what was common in the group of people mentioned above (diabetes, grave's disease, deranged hormone levels, pituitary dysfunction and so forth) and which all profited from a prolamine-reduced (free if necessary) diet. Gluten-free alone didn't it.
Best regards.
212.202.0.156 10:58, 13 August 2005 (UTC)
thread_title: Gramineae

message: The disease is universally known as celiac disease, not coeliac disease.  I recommend using "celiac" throughout the document, and putting "coeliac" in the "also known as _______ disease" sentence.
:Yeah, the World Health Organization calls it Celiac.  Pretty much everyone except the British call it Celiac.
::Would the fact that British people seem to be far more likely to have coeliac disease have any bearing on this? And the usual rule about, if there is a conflict of regional spellings in an article that isn't about a specific region, going with the style of the first author? Just wondering. 57.66.51.165 16:59, 28 February 2006 (UTC)
replies: text: It's been amusing me on the spelling.  I didn't know the WHO called it Celiac.  I've been deferring to the Brits on this just cause there a bunch of very good docs from the island here on Wikipedia.  But with the WHO calling it celiac, well, that is a pretty reasonable example of a legitimate authority on things medical.  Kd4ttc 02:30, 1 March 2006 (UTC)

text: I'd say do a move request. But in general, Wikipedia does not automatically follow US spelling, even if there may be Google support. This is a traditional issue. JFW | T@lk 00:07, 7 March 2006 (UTC)
thread_title:  Coeliac disease 

message: dear all,
what is the status of millets for celiac patients? i noticed that the article doesn't mention this, but there is a brief reference to it on this page.
best, Mumun 14:44, 22 February 2006 (UTC)
replies: text: It is gluten free. Kd4ttc 23:13, 22 February 2006 (UTC)
thread_title:  status of millets  

message: From the article:
Rarely, coeliacs may experience symptoms similar to those of sinus infections and/or the formation of thick, choking plugs or ropes of mucus that require considerable effort to expel.
I suspect I might have wheat allergy or coeliac disease - is there a difference between the two?  I have an appointment with an allergist at the end of the month.  It never dawned on me that the reocurring cough I have might be caused by gluten.  When I get a cold, I often cough up clear phlegm for a few weeks after.
But my searches through other coeliac (or celiac) pages have turned up zilch about coughing and phlegm, despite it being mentioned here.  Is this a controversial issue?  Is there a source for this so-called more rare symptom, given that the main coeliac websites make no mention of it?
Thanks.  Nikolaus maack 18:53, 7 March 2006 (UTC)
replies: text: The following discussion is an archived debate of the proposal. Please do not modify it. Subsequent comments should be made in a new section on the talk page. No further edits should be made to this section. 
The result of the debate was don't move. —Nightstallion (?) 10:25, 13 March 2006 (UTC)
thread_title:  coughing?  

message: :Add *Support or *Oppose followed by an optional one-sentence explanation, then sign your opinion with ~~~~
*Support Celiac is spelling used by World Health Organization. Kd4ttc 14:26, 8 March 2006 (UTC)
thread_title: Vote

message: As this is partly a genetic disease, a section should be added on what racial / ethnic groups are predisposed to this disorder and what the affected percentages of those groups are. —The preceding unsigned comment was added by Flask (talk • contribs) .
:I think it's in the epidemiology section: Coeliac disease#Epidemiology -- Samir   धर्म 05:12, 17 May 2006 (UTC)
thread_title:  A section on genetics? 

message: Anti-gliadin antibodies (AGA), IgG and IgA. These tests are often useful when testing young symptomatic children, but they are found in fewer coeliacs than Anti-tTG, and their presence does not automatically indicate coeliac disease because they are found in some other disorders.
:Can we get a reference to one of these other disorders? Btyner 00:05, 24 May 2006 (UTC)
thread_title:  false positive IgG 

message: A userful timeline, which may help us find relevant references for historical background. JFW | T@lk 23:38, 14 June 2006 (UTC)
thread_title: History

message: I'm colllecting useful sources in preparation for a major expansion. Having given a succesful talk about this condition last Friday I think this article is a bit of an embarrassment.
* Historical:
** Aretaeus of Cappadocia, translated by Francis Adams and printed for the Sydenham Society in 1856
** Biographical and Bibliographical data on Samuel Gee, Whonamedit entry. 
** Dicke WK. Coeliakie. PhD thesis. The Netherlands: University of Utrecht, 1950.
* Clinical:
**  - risk of malignancy
**  - coeliac neuropathy
* Immunology:
** Epitope: 
* Genetics:
**  (genome-wide screen)
* Epidemiology and genetics:
**  screening
* Recent reviews:
**  - Gut very broad review
** Use of serology (systematic review)
I'm not proposing to refer to each of these articles, but these are resources that I think may be useful. JFW | T@lk 22:31, 19 June 2006 (UTC)
replies: text: Enzyme therapy, something to watch (when the human trials become available): JAMA. JFW | T@lk 06:53, 26 July 2006 (UTC)
thread_title:  Expansion and sourcing: a list of useful sources 

message: A big part of what's missing.  Autoimmune disease associations (collagenous colitis, PBC, T1DM, etc.) and complications (jejunoileitis, SB Ca, lymphoma, esophageal/pharyngeal Ca) need to be mentioned and referenced -- Samir   धर्म 09:47, 21 June 2006 (UTC)
replies: text: Do you have a good single source that parses all these associations nicely into a citable list? JFW | T@lk 16:31, 3 September 2006 (UTC)
thread_title:  Disease associations and complications 

message: Many section are referenced to what constitutes (in my view) a set of unreliable sources. The websites linked to may be popular and such, but many don't state on which studies they base their statements. If there are studies available, these certainly deserve priority over secondary sources.
I have expanded the historical section. Should we mention how Anderson purified gluten and how the small bowel biopsy was developed (both by women, incidentally, in the male chauvinistic 1950s). JFW | T@lk 11:22, 24 August 2006 (UTC)
replies: text: Yes!  I'm unaware of the history of the small bowel biopsy -- Samir   धर्म 11:26, 24 August 2006 (UTC)

text: It's remarkable that almost all early-days research into coeliac disease took place in Europe. Does the condition exist accross the Atlantic? :-) JFW | T@lk 02:00, 27 August 2006 (UTC)
replies: text: We have a similar disease called celiac disease :)  The ligature fell off the Mayflower. -- Samir   धर्म 06:11, 28 August 2006 (UTC)
replies: text: Heh. JFW | T@lk 21:44, 28 August 2006 (UTC)

text: I suspect it has a lot to do with major crops. In Europe, wheat is by far the major grain crop, and grain derivatives (modified starches, dextrose, maltodextrin, etc.) are largely derived from wheat there (and in Australia and New Zealand). The USA has maize as probably its major grain crop, and such derivatives therefor come from maize instead. Just a theory... Webaware 07:10, 28 August 2006 (UTC)
replies: text: So American's ain't eatin' no bread, man? JFW | T@lk 21:44, 28 August 2006 (UTC)
replies: text: Hey, nice tone! Must make you feel more important. My point was simply that, as North America has so much maize, there is more money around for research relating to it than to other foods. Not to mention, the revolving door employment scenario between USDA and major food producers in the USA, which helps shape the regulatory environment there. Webaware 02:55, 3 September 2006 (UTC)
replies: text: The corn theory is an interesting one.  There's not much published on it, but it has certainly come up at a couple of conferences.  Also, I think JFW was just making a joke.  About cornbread. :) -- Samir धर्म 09:32, 3 September 2006 (UTC)
thread_title:  Referencing and junking 

message: The AGA has also issued a guideline (2001, reviewed unchanged 2004), although it seems to have been written by Brits (see here and ). JFW | T@lk 01:52, 3 September 2006 (UTC)
replies: text: This should be the best reference for the bulk of the clinical part of the article.  The 2004 technical review is excellent -- Samir धर्म 01:57, 3 September 2006 (UTC)
thread_title:  AGA 

message: - a series of coeliakoid biopsies that were not, in fact, due to coeliac. We should include a differential diagnosis for the "typical" biopsy appearance. Whipple's, anyone? 
JFW | T@lk 02:01, 3 September 2006 (UTC)
replies: text: Classic exam question: Tropical sprue, Giardia, Radiation, Crohn's, NSAID enteropathy, lymphoma, abetalipoproteinemia, eosiniphilic enteritis, ZE, HIV, bacterial overgrowth, amyloid, hypogammaglobulemia.  R0xx0r -- Samir धर्म 02:11, 3 September 2006 (UTC)

text: Wish I did, but I just forgot the "of Canada".  September 20-21, or as I like to call it, doomsday.  PACES looks challenging, unlike Canadian exams.  Back to celiac disease, I just made small bowel bacterial overgrowth syndrome; have a peek -- Samir धर्म 09:36, 3 September 2006 (UTC)
thread_title: Jokers

message: The Cambridge study suggested a benign cardiovascular risk profile due to the malabsorption, but this paper in Am J Med seems to suggest that while TC and LDL go up, LDL:HDL goes down. JFW | T@lk 08:22, 3 September 2006 (UTC)
replies: text: Malabsorption is usually associated with a low HDL, which we also know is an independent lipid RF for CAD.  My understanding was the low HDL in celiac was of unclear significance, and I'm also not too sure what the significance of an increased HDL post treatment is. -- Samir धर्म 10:30, 3 September 2006 (UTC)
thread_title: Lipids

message: I've only found patchy research on the quality of life, social stigma and actual mortality figures. These are essential in making the article complete.
I'm thinking of ditching a lot of information presently redundant with gluten-free diet. I'm also planning to drastically shorten the "religious implications" section. Perhaps it can be forked.
There's of course plenty to do, but with some heavy editing behind me I was wondering if we shouldn't send this baby for peer review at some point. Samir, whaddaya think? JFW | T@lk 14:59, 3 September 2006 (UTC)
replies: text: All done now. A good QOL/psychological comorbidity study was found and duly cited. I'll be requesting an unofficial peer review from WP:CLINMED before officially sending it for WP:PR. JFW | T@lk 16:31, 3 September 2006 (UTC)
replies: text: It looks very very good.  I'll add a few additional pearls over the next bit -- Samir धर्म 17:03, 3 September 2006 (UTC)
thread_title:  Quality of life 

message: I've added a sentence to the intro, covering the approximate prevalence in Caucasian populations. I think that briefly establishing how common or rare a disease is, is an important point to get accross in the intro. It is all part of getting the reader's attention. I took this data from the conclusion in the vanHeelWest paper that forms the core reference for the article. I think their use of the word "Caucasian" gives a good indication of the population affected, which appears to include the Middle-East and India, as well as folk of European descent. If you know better, please change. Colin°Talk 12:02, 5 September 2006 (UTC)
thread_title: Intro

message: I've reviewed the WP:MEDMOS against this article. There are some (optional) sections that could be considered here. Here are just some suggestions for thought – there is no need to defend their current exclusion.
*Causes (or Etiology). The very technical aspects of the genetic changes and consequent reactions to gluten are covered in the Pathophysiology section. It is a complex subject and I have no problem with the expert-level language used here. It is, of course, quite opaque to the general reader. This topic is covered very briefly in plain-English in the (long) intro. Should that text get expanded, then this might be the section to create for it.
*Prognosis. The lifelong aspect of the disease is briefly stated in the intro. Can any more be said? The references mention some research on the long-term implications of undiagnosed coeliac disease.
*Prevention/Screening. I mentioned prevention earlier. Screening is currently covered as a subsection of Diagnosis.
*Social Impact. Currently there is "Social and religious issues", which is dominated by religious issues. Non-religious social aspects include the ease of implementing the GFD (e.g. no products in Third World countries, prescriptions), teenage non-compliance, getting medical insurance to pay for tests, etc. Perhaps the religious issues could be demoted to a sub-heading and probably abbreviated. 
*External links. I thought these went at the end?
One purpose of having these sections is that the reader will come with the big questions: "What caused it", "What will happen to me/them", "How can I prevent it" – and currently they have to work hard to locate and understand their detailed answers. Creating a short section may be a trigger that encourages another editor to add more and ultimately produce a satisfying paragraph or so.
Other resources I've found:
* A non-copyright NIH article on celiac disease that could be a source of plain-English text, if appropriate.
* NIH Consensus Development Conference on Celiac Disease 2004
Colin°Talk 12:58, 5 September 2006 (UTC)
thread_title: Medical manual of style

message: I've been brave and sent an email to Prof Paul Ciclitira, a gastroenterology professor at KCL in London who has an interest in coeliac disease and has written both the BSG guidelines and the AGA technical review (2001). He has asked one of his registrars to review the article. I'll post any comments over here. JFW | T@lk 16:41, 4 September 2006 (UTC)
replies: text: Great idea- even better peer review. alteripse 22:11, 4 September 2006 (UTC)
thread_title: External peer review

message: Can anyone find a free image of the Marsh classification?  It would be an exceptional addition to the article's basic science content.  -- Samir धर्म 10:05, 8 September 2006 (UTC)
replies: text: Not seen much at all on various websites I've seen. Perhaps your local pathologist would be able to assist? JFW | T@lk 19:30, 12 September 2006 (UTC)
replies: text: I asked WikipedianProlific, whose first draft looked very promising. -- Samir धर्म 07:52, 13 September 2006 (UTC)
thread_title:  Marsh classification 

message: Does anyone test this anymore?  I haven't since I was a resident.  The operating characteristics are abysmal.  Is it still used in pediatrics? -- Samir धर्म 10:31, 8 September 2006 (UTC)
replies: text: My hospital uses anti-endomysial. In my previous hospital I gave a talk about coeliac (which is the basis for my work on this article). At one point the cardiologist asked: "Do they still use ground-up monkey oesophaguses for that?" Turns out that anti-reticulin antibodies are indeed determined on tissue blocks from monkey oesophagus. Thankfully they're out of fashion (even more than anti-gliadin). JFW | T@lk 19:30, 12 September 2006 (UTC)
replies: text:  Not only monkey oesophagus, but human intestine and human umbilical cord are also used for that purpose. --WS 20:15, 12 September 2006 (UTC)
replies: text:  And tTG is sometimes purified from cavia livers (but also available as recombinant human tTG) :-). --WS 20:18, 12 September 2006 (UTC)

text:  anti-endomysial antibodies are still useful in scientific work as the recent study of EMA-negative patients has revealed the presence or absense of different anti-tTG types can be used to subclassify tTG, see reference #24.  As far as AGA is concerned, the disease appears to be mediated by DQ2/8 gliadin restricted T-cells, so that the importance of anti-gliadin is ambiguous. Other than this the page does not elucidate the fact that alpha and to a much lessor degree gamma gliadin are triggering agents, omega gliadins are involved in allergies that may be independent of CD, and glutinen is a factor in DQ8 restricted disease. Omega is a factor in Baker's allegy is and exercise induced anaphalaxis, some better wording of gliadin should be made. prd(10-2-2006)
You mean guinea pig? Don't mention the fact that early reagents for the prothrombin time were made from puréed human brain. Heh. JFW | T@lk 15:52, 21 September 2006 (UTC)
thread_title:  Anti-gliadin antibody 

message: Classic teaching from textbooks (Sleisenger and Yamada both) is that celiac is associated with webs (both symptomatic and found incidentally) but I can't seem to find a reference in the literature.  It's a (very) minor point, but thoughts? -- Samir धर्म 23:45, 13 September 2006 (UTC)
replies: text: Never heard of it. Could it be spurious? JFW | T@lk 15:52, 21 September 2006 (UTC)
thread_title:  Celiac and esophageal webs 

message: The article looks fabulous as it is but just a couple more pretty pictures would make this perfect:
*We've got the Marsh classification image cooking
*Dermatitis herpetiformis would be a very neat image (as would IF of the IgA deposits -- that would be the money).  I don't have a picture of one.
*I can try to find more small bowel endoscopy pictures but I don't think I have many (any?).  I had a beautiful ulcerative jejunitis picture but haven't been able to find it for the past week
*The TTG picture? -- Samir धर्म 00:50, 14 September 2006 (UTC)
thread_title:  Images 

message: "While a role for carbohydrates had been suspected, the link with wheat was not made until 1950 by the Dutch paediatrician Dr Willem Dicke.[38]"
This is from the middle of the history section.
:Yes, it is. There were several theories prior to Dicke's observation, but most of those involved nutritional carbohydrate content. JFW | T@lk 15:52, 21 September 2006 (UTC)
thread_title:  Sentence correct? 

message: As I stated above, I asked Prof Paul Ciclitira (Rayne Unit, London) for a proofreading. He delegated this to Dr Simon McLaughlin, one of his research registrars, who kindly went through the whole page and emailed me with the following comments (reproduced here with permission):
:I have finally read through your coeliac article. I think this is very good. My only comments would be:
:# I don't like the term DMARDs used outside the context of rheumatology! It is best to use the term 'immunomodulator' or 'steriod sparing agent' for both Azathioprine and methotrexate.  We have never used infliximab in non-responsive coeliac, this condition is rare and we have a paper which we are soon to submit looking at the Ix and Mx of over 100 cases referred to Prof C, most of these had an alternate diagnosis! The remainder have been treated with prednisolone and Azathioprine and this is the standard of care. To my knowledge infliximab has only been used in 1 or 2 case reports and I think should probably be classified as an experimental treatment, certainly this is not included in our current BSG guidelines (which are soon to be published).
:# re epidemiology I have copied the following text from the latest (unpublished) guidelines:
:#: Epidemiological studies in the UK have indicated the prevalence of coeliac disease to be between 0.5-1.0%. There are figures of the same order of magnitude in Caucasian populations worldwide including the USA, South America (2) and  Australia. Coeliac disease appears to be uncommon in non-Caucasians but the prevalence is less well defined. There may be geographical sparing in regions that have a rice-based diet. 
:#: From these studies, there is a clear gap between the estimated prevalence of coeliac disease in the general population and the number of people who have actually been diagnosed. This suggests that there is a large excess of undiagnosed individuals, possibly as many as 5-10 cases for each existing patient (3). In the US, with an expected prevalence of about 1%, the number of registered cases amounts to only about 1 in 1000 of the population (4). 
:# I think the italian and English epidemiology figures are probably a bit out of date.
:I hope this is helpful. Simon McLaughlin, Research fellow and Gastroenterology SpR
I will have another look at the epidemiology section, and was wondering what Samir's views were on the infliximab section. JFW | T@lk 15:52, 21 September 2006 (UTC)
replies: text: Agreed that anti-TNF therapy for celiac is still investigational:  . -- Samir धर्म 00:24, 25 September 2006 (UTC)

text: The term DMARD is also rarely used in gastroenterology.  I prefer immunomodulator myself -- Samir धर्म 00:26, 25 September 2006 (UTC)
thread_title: External review

message: Time for another go? -- Samir धर्म 22:43, 25 October 2006 (UTC)
replies: text: It's nearly ready, and a lot better than the previous FAC nomination, but there are still a few citations needed. --apers0n 07:21, 3 November 2006 (UTC)

text: Why not nominate it for GA status?  Surely it will achieve that. Wikipediarules2221 00:34, 24 February 2007 (UTC)
thread_title:  FAC? 

message: suggests that oats, while clinically not much different, may still have the same long-term risks as other grains. Should be mentioned, uh? JFW | T@lk 16:12, 7 November 2006 (UTC)
replies: text: (1) Celiacs who eat oats tend to have worse histology than those who do not.  (2) We don't know the relevance of that entirely.  It may confer higher long term risks -- Samir धर्म 01:15, 8 November 2006 (UTC)

text: Hi Jennifer, people who have dermatitis herpetiformis and a family history of celiac disease should probably have testing done for celiac disease -- Samir धर्म 23:47, 22 December 2006 (UTC)
thread_title: Oats