MEDSCAPE UPDATE

Two new articles on Medscape deal with celiac disease.

"Coeliac Disease: Relationship to Endocrine Autoimmunity" is a case study of a man who was treated successfully for Addison's disease and type 1 diabetes, but received a diagnosis of celiac disease after showing symptoms of fatigue and iron deficiency anemia about 15 years into his treatment for the other conditions.

An accompanying discussion identifies common celiac symptoms as malabsorption (60%), lethargy (50%), and anemia (12-22%) but notes that physical examination is often normal. It lists associated disorders as fatty liver disease, dermatitis herpetiformis, epilepsy, neuropathy, male and female infertility, Addison's disease, and type 1 diabetes. It also observes that cigarette smoking reduced the risk of celiac disease by 80%--though I'd recommend consulting with a physician before taking up smoking as a preventative therapy. The article appears in The British Journal of Diabetes and Vascular Disease (Volume 6, Number 6, 2006).

"Advances in Celiac Disease" is a multi-part summary of "recent critical research in celiac disease." I could actually use a summary of the summary, but here are three of the points that stood out for me:

Celiac disease screening among women of reproductive age could yield significant health benefits.

Primary care doctors are increasingly involved in identifying celiac disease patients.

A Finnish and Hungarian group is developing a point-of-care testing kit that would yield results within 30 minutes.

This report appears in Current Opinion in Gastroenterology (Volume 23, Number 2, 2007).

The former study put the frequency of celiac disease at 1 in 200; the latter as possibly as high as 1 in 100.