Celiac disease: clinical update
Purpose of review This review highlights literature from the past year and explores the impact on current understanding of celiac disease pathogenesis, diagnosis, and management. Recent findings In contrast to earlier clinical trials, recent data suggests that early gluten introduction may protect against the development of celiac disease. Celiac disease is underdiagnosed, associated with high burden of disease and linked to excess mortality risk, yet, there remains considerable uncertainty regarding the utility of mass screening in asymptomatic individuals. The gut microbiome is increasingly implicated in celiac disease pathogenesis, although the exact mechanism is undefined. Probiotics have been proposed as a disease-modifying option for celiac disease but most studies assessing efficacy are of low-quality. Patients with celiac disease do not appear to be at increased risk of contracting or developing adverse outcomes from COVID-19. Little is known about the pathogenesis of nonceliac gluten sensitivity; however, recent findings suggest an autoimmune basis for the condition. Summary Current understanding of celiac disease continues to advance, though significant knowledge gaps remain. Large, rigorous, prospectively designed studies are needed to further characterize celiac disease pathogenesis, management and therapeutic options.
Nature, Published online: 14 July 2021; doi:10.1038/d41586-021-01834-xLinks between COVID-19 and autoimmunity, a better model of coeliac disease, and other highlights from clinical trials and laboratory studies.
This study aims to investigate the incidence of SARS-CoV-2 infection in CD patients, to assess the impact of CD on the risk of contracting this virus.PATIENTS AND METHODS: This retrospective multicentric cohort study evaluated 542 celiac patients, who answered a questionnaire concerning both the underlying disease (adherence to the gluten-free diet, residual symptoms) and the possible SARS-CoV-2 infection (swab outcome, presence and characteristics of symptoms and type of treatment received), referring to the period between 20th January 2020 and 27th October 2020.RESULTS: Five patients (0.92%) tested positive; of these, 2 ...
Serum sickness, an immune-complex-mediated hypersensitivity reaction, is more common in adults than children. Rituximab has been reported as an agent that can cause serum sickness. This case discusses a pediatric patient who developed rituximab-induced serum sickness in the setting of a positive history of COVID-19 and recently diagnosed neuromyelitis optica, celiac disease, immune thrombocytopenia, and Sjogren ’s syndrome.