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Osteopenia In Childhood 

sclerodermaWhat Is Scleroderma?

[dropcap]S cleroderma is a chronic skin manifestation of progressive systemic sclerosis characterized by generalized thickened, edematous skin firmly bound to subcutaneous tissue which causes limited movement.

Systemic sclerosis a connective tissue disease that involves destructive changes in the skin, blood vessels, muscles, and internal organs. The course can be mild or it can be fatal. Cardiopulmonary complications from fibrosis are the most common cause of death.

Gastrointestinal problems mainly due to fibrosis affect 50 to 90% of patients.1

Q: Is there a cure for scleroderma?

A: There is no cure for scleroderma. Treatment is aimed at improving symptoms.

  • Heartburn (acid reflux) can be treated with antacid drugs.
  • Scleroderma kidney disease can be treated with blood pressure medications called “angiotensin converting enzyme inhibitors” (ACE inhibitors). These can often effectively control kidney damage if started early and use of these drugs has been a major advance for treating scleroderma.
  • Muscle pain and weakness can be treated with anti-inflammatory drugs such as prednisone, intravenous immunoglobin (IVIg), and/or immunosuppressive medications. Physical therapy may be useful to maintain joint and skin flexibility.2

 

What Is Scleroderma In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Forbes A, Marie I. Gastrointestinal complications: the most frequent internal complications of systemic sclerosis. Rheumatology (Oxford). 2009 Jun;48 Suppl 3:iii36-9. doi: 10.1093/rheumatology/ ken485. [↩]
  2. http://www.rheumatology.org [↩]

Penicillin V Impaired Absorption in Children 

osteomalacic myopathy in celiac diseaseWhat Is Osteomalacic Myopathy?

[dropcap]O steomalacic myopathy is a major feature of osteomalacia that is characterized by painful muscle weakness involving the thighs and upper arms and hyperreflexia.

Q: What is hyperreflexia?

A: Hyperreflexia means the action of reflexes is increased. Reflex action is an involuntary, or automatic, response to a stimulus. A reflex action is complicated but essentially depends on  a normal responding muscle which is altered in osteomalacia.

Osteomalacic myopathy is diagnosed on bloodwork that shows deficient levels of vitamin D and elevated levels of parathyroid hormone and alkaline phosphatase, a bone enzyme.

What Is Osteomalacic Myopathy In Celiac Disease and/or Gluten Sensitivity?

Pneumococcal Septicemia 

Endoscopic image of Crohn'sDisease showing deep ulceration in sigmoid colon.
Endoscopic Image of Crohn’s Disease Showing Deep Ulceration in the Sigmoid Colon.

What Is Crohn’s Disease?

[dropcap]C rohn’s disease is an inflammatory bowel disease characterized by patchy inflamed areas involving the full thickness of the intestinal wall that can occur anywhere in the intestinal tract, in addition to, mucosal disease.

In Crohn’s disease there is ongoing immune activation which produces inflammation and ulceration but the cause is not known and the severity varies among patients. At diagnosis of Crohn’s disease, factors predictive of subsequent 5-year aggressive disease are an age below 40 years, the presence of perianal disease, and the initial requirement for steroids.1

Dysbiosis is a factor that develops in and worsens Crohn’s disease and stress is a factor in both of these conditions. Psychological stress activates multiple physiological processes aimed at maintaining balance within the body. These physiological processes also have the capacity to influence the composition of microbial communities in the digestive tract, and research now indicates that exposure to stressful stimuli leads to gut microbiota dysbiosis.2

While the relative abundance of many different bacterial types can be altered during stressor exposure, findings in nonhuman primates and laboratory rodents, as well as humans, indicate that bacteria in the genus Lactobacillus are consistently reduced in the gut during stress.2

Q: Is there a cure for Crohn’s disease?

A: Presently, Crohn’s disease cannot be cured. This condition has a course of remissions, when symptoms subside, and flares, when symtpoms get worse. Treatment is aimed to reduce flares and promote remission.

What Is Crohn’s Disease In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Beaugerie L, Seksik P, Nion-Larmurier I, Gendre JP, Cosnes J. Predictors of Crohn’s disease. Gastroenterology. 2006;130:650–656. [↩]
  2. Galley JD, Bailey MT. Impact of stressor exposure on the interplay between commensal microbiota and host inflammation. Gut Microbes. 2014 May 1;5(3):390-396. Epub 2014 Apr 1. [↩] [↩]

Osteitis Fibrosa Cystica 

Deep Vein Thrombosis in the Right Leg with Swelling and Redness. Coutesy wikipedia.
Deep Vein Thrombosis in the Right Leg with Swelling and Redness. Courtesy wikipedia.

What Is Antiphospholipid Syndrome?

Antiphospholipid syndrome (APS) is an autoimmune disease and a blood clotting disorder characterized by these clinical and laboratory criteria:

Clinical criteria – recurrent vascular thrombosis (clots in veins/arteries) from hypercoagulability (abnormal excessive clotting) and/or recurrent complications of pregnancy that include loss of the fetus  (miscarriage) and pre-eclampsia or eclampsia.

Laboratory criteria – persistently elevated anticardiolipin, anti–beta-2 glycoprotein I, and/or lupus anti-coagulant antibodies in blood.

In antiphospholipid syndrome autoantibodies are produced by the body and directed against negatively charged phospholipids that are found in the outer layer of cell membranes and platelets. B2-glycoprotein-I (a protein in blood plasma) has been found as a major target antigen for antiphospholipid antibodies.

Q: Are phospholipids important in the body?

A: Yes.  Phospholipid molecules are an essential part of cell membranes. They form a barrier around cells that protect the cell, allow movement of oxygen in and carbon dioxide out of the cell, and regulate other small molecules through the cell wall. Because phospholipids are widespread in the body, this disorder can produce a large variety of symptoms and affect many organs.

One severe effect of APS is the development of a blood clot in a vein deep in the arm or leg, called deep vein thrombosis (DVT). DVT can cause pain, swelling, redness, or increased warmth in the affected limb. Deep vein clots can break off, travel to the lungs, and cause pulmonary embolism.1 Pulmonary embolism is a medical emergency.

Treatment is with anticoagulant medications and blood monitoring.

What Is Antiphospholipid Syndrome In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. http://www.nhlbi.nih.gov/health/health-topics/topics/ebc/signs.html [↩]

Osteomalacia

Drawing shows changes in airways during asthma attack. wikipedia
Drawing shows changes in airways during asthma attack. wikipedia

What Is Asthma?

Asthma is a chronic immune respiratory condition characterized by narrowing and inflammation of the lung airways (large bronchi, bronchial tubes and small bronchioles) in response to an allergen as the trigger or stimulus. As such, asthma occurs in episodes and does not result in progressive loss of pulmonary function.

During an asthma attack, airways constrict, trapping air so lungs become overinflated.  Normally, bronchial airways bring air to millions of air sacs that are attached to the ends of bronchioles. Air sacs, called alveoli, are only one cell thick to allow for rapid exchange of gases.

That is, oxygen from air breathed into the sacs moves into the bloodsteam and carbon dioxide is released from the bloodstream to air that is breathed out of air sacs.

The outer walls of bronchioles are made up of muscles which, in the process of breathing, normally contract on expiration to help expel air and then relax. During an asthma attack, these muscles abnormally constrict, impairing airflow into and out of the alveoli. This is called bronchospasm.

Common  allergens that cause inflammation include airborne dust mite feces, mold, and pollen and foods such as wheat, cow’s milk, eggs, and peanuts. Non-allergenic triggers include exercise, air pollution, smoking, and viral respiratory infection.

Q: What effect does inflammation have on the lungs?

A: Inflammation causes local tissue edema or swelling of the bronchioles and mucus formation. Inflammation with increased mucus secretions and edema narrows the airways that connect to alveoli which makes breathing difficult.  Two things happen:

  1. Inflammation  impairs exchange of gases in alveoli, resulting in lack of sufficient oxygen (O2) for body cell functions, called hypoxia, and build-up of carbon dioxide (CO2) in blood, called CO2 retention.
  2. Inflammation narrows passageways because of swelling, which reduces the movement of air to and from the alveoli through the airways, and this puts stress on the right side of the heart.

Treatment is aimed at controlling bronchospasm and reducing inflammation. Untreated asthma can be disabling and life threatening.

What Is Asthma In Celiac Disease and/or Gluten Sensitivity?

Osteonecrosis

Each antibody binds to a specific antigen; an interaction similar to a lock and key. Courtesy Wikipedia.
Each antibody binds to a specific antigen; an interaction similar to a lock and key. Courtesy Wikipedia.

What Are Autoimmune Disorders?

[dropcap]A utoimmune disorders refer to those conditions that involve an abnormal immune attack on the body’s own tissues perpetuated by the production of autoantibodies directed against the body, or “self.” Auto means self.

Q: Why does the immune system attack the body?

A: The exact answer is not yet known why the immune system turns against body tissue or “self.” 

Normally, the immune system protects the body from harmful substances and pathogens and produces antibodies against the offending foreign substances, called antigens, to get rid of them. The immune system (humoral) thereafter remembers all antigens and is ready for the next encounter should it happen.

Production of autoimmune antibodies is catastrophic because there is no turning off the readiness to attack a remembered threat (antigen) which is unfortunately “self.” 

Yes, steroids and anti-inflammatory drugs can control symptoms, but nothing can undo the memory programmed into the immune system to produce autoantibodies. There is an enormous research effort ongoing for the answer. 

Autoimmune disorders cover a wide range of diseases that may target only a particular organ, such as autoimmune hepatitis (liver), while others are systemic because the autoantibodies target a particular tissue that is part of more than one organ, such as scleroderma (connective tissue).

Autoimmune diseases as a group affect approximately 8.5% of people worldwide.

What Are Autoimmune Disorders In Celiac Disease and/or Gluten Sensitivity?

Bleeding, Occult Gastrointestinal

Erosions Of The Esophagus Can Be A Cause Of Gastrointestinal Bleeding.
Erosions Resulting From Esophagitis Can Be A Cause Of Gastrointestinal Bleeding.

What Is Occult Gastrointestinal Bleeding?

[dropcap]O[/dropcap]ccult gastrointestinal bleeding is characterized by unseen or minute quantities of blood in stool. The origin of bleeding is from mucosa that lines the inside of the digestive tract at a site that must be found by medical testing and procedures to look at the lining.

Q: What tests and procedures are performed to locate the bleeding?

A: The simplest test to discover blood that cannot be seen is the stool test. This consists of a card with 3 spaces for 3 separate  stool collection over 3 separate days. A tiny smear of stool is placed on a test card space on each of three days. Then the card is examined for a reaction that indicates the existence of blood in the stool.

If the stool test is positive, the origin of bleeding must be located. This search requires certain procedures that look at the mucosal lining directly by a gastroenterologist, usually under light sedation.

  • Gastroscopy procedure can visualize the upper gastrointestinal tract, which includes the esophagus and stomach.
  • Endoscopy procedure can also visualize the upper small intestine. However, endoscopy procedure is limited in that it cannot visualize the middle small intestine (jejunum).
  • Colonoscopy can visualize the end of the small intestine and colon all the way to the rectum.
  • Capsule endoscopy procedure.  If  gastroendoscopy and colonoscopy fail to discover the source of bleeding, the physician may administer a capsule endoscopy which visualizes the entire gastrointestinal tract. In this procedure, the patient swallows a capsule size camera (encased) which takes constant pictures over the course of a day until expelled through the rectum.  Of course, the patient must be able to swallow the large size capsule.

What Is Occult Gastrointestinal Bleeding In Celiac Disease and/or Gluten Sensitivity?

Cancer, Parathyroid

hypocupremia low copper and celiac disease gluten symptom
Paleness and Tendon Problem: Symptoms of Hypocupremia.

What Is Hypocupremia?

[dropcap]H ypocupremia, or low plasma copper, means the level of copper is too low to meet metabolic needs of the body for copper and is characterized by these many features:

  1. Impaired energy production causing weakness.
  2. Impaired ability as part of an enzyme to oxidize vitamin C which is required to breakdown histamine.
  3. Faulty blood cell formation and instability of blood cell membranes causing anemia, shortened life span of neutrophils causing susceptibility to infection, faulty platelet formation causing impaired blood clotting.
  4. Faulty elastin formation causing weak blood vessels.
  5. Poor collagen and connective tissue strength causing joint and tendon problems and weak bones causing deformities, faulty bone mineralization causing fragile bones.
  6. Loss of proprioception causing ataxia.
  7. Loss of pigmentation of hair and skin.
  8. Impaired thyroid function.
  9. Impaired adrenalin production.

Untreated, copper deficiency can advance to brain degeneration. Failure to make normal blood cells can result in death.

What Is Hypocupremia In Celiac Disease and/or Gluten Sensitivity?

Melanoma

Enamel_celiac[1]What Are Dental Enamel Defects?

[dropcap]D ental enamel defects (DED) comprise a variety of abnormalities in the dental enamel of the second or permanent teeth and of primary or baby teeth.

Teeth may appear with pits, thin or missing enamel, non-white enamel (yellow, orange, or gray colored teeth), and demarcated opacities (very white spots) even if teeth are white.

Q: What is enamel?

A: Dental enamel is the shiny, hard, white, dense, inorganic substance covering the crowns of the teeth. The crown is the tooth portion above the gum. Under the enamel is hard dentin which surround the living pulp. In teeth with missing enamel, the areas with exposed dentin appear dull and tan colored.

What Are Dental Enamel Defects In Celiac Disease and/or Gluten Sensitivity?

Lymphoma, B-Cell Non-Hodgkin’s

e3343bf0a689b5f974a852fa2e84a718What Is Laryngospasm?

[dropcap]L aryngospasm is an acute disorder of the larynx that is characterized by life-threatening spasms of the muscles of the larynx located in the throat.

Laryngospasm is a rare feature of hypocalcemia (low blood calcium level) characterized by severe alteration in nerve conduction and muscle contraction.

What Is Laryngospasm In Celiac Disease and/or Gluten Sensitivity?