PubMed | Allergology and Clinical Immunology Unit, Santa Maria del Prato Hospital, Italian National Cancer Institute, Gastroenterology Unit ASST Santi Paolo e Carlo Milan and 7 more.
Type: | Journal: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver | Year: 2016
Gluten-related disorders is a term that encompasses different diseases induced by the ingestion of gluten-containing food. Because of their incidence the scientific community has been intensively studying them.To support gastroenterologists with a correct nomenclature and diagnostic approach to gluten-related disorders in adulthood.The Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) commissioned a panel of experts to prepare a position statement clarifying the nomenclature and diagnosis of gluten-related disorders, focusing on those of gastroenterological interest. Each member was assigned a task and levels of evidence/recommendation have been proposed.The panel identified celiac disease, wheat allergy and non-celiac gluten sensitivity as the gluten-related disorders of gastroenterological interest. Celiac disease has an autoimmune nature, wheat allergy is IgE-mediated while the pathogenesis of non-celiac gluten sensitivity is still unknown as is the case of non-IgE mediated allergy. Diagnosis should start with the serological screening for celiac disease and wheat allergy. In case of normal values, the response to a gluten-free diet should be evaluated and a confirmatory blind food challenge carried out.Gluten-related disorders are clinically heterogeneous. Patients should be carefully managed and specific protocols applied for a correct differential diagnosis in gastroenterological setting.
Elli L.,Center for the Prevention and Diagnosis of Celiac Disease |
Elli L.,University of Milan |
Branchi F.,Center for the Prevention and Diagnosis of Celiac Disease |
Branchi F.,University of Milan |
And 10 more authors.
World Journal of Gastroenterology | Year: 2015
Cereal crops and cereal consumption have had a vital role in Mankind's history. In the recent years gluten ingestion has been linked with a range of clinical disorders. Gluten-related disorders have gradually emerged as an epidemiologically relevant phenomenon with an estimated global prevalence around 5%. Celiac disease, wheat allergy and non-celiac gluten sensitivity represent different gluten-related disorders. Similar clinical manifestations can be observed in these disorders, yet there are peculiar pathogenetic pathways involved in their development. Celiac disease and wheat allergy have been extensively studied, while non-celiac gluten sensitivity is a relatively novel clinical entity, believed to be closely related to other gastrointestinal functional syndromes. The diagnosis of celiac disease and wheat allergy is based on a combination of findings from the patient's clinical history and specific tests, including serology and duodenal biopsies in case of celiac disease, or laboratory and functional assays for wheat allergy. On the other hand, non-celiac gluten sensitivity is still mainly a diagnosis of exclusion, in the absence of clear-cut diagnostic criteria. A multimodal pragmatic approach combining findings from the clinical history, symptoms, serological and histological tests is required in order to reach an accurate diagnosis. A thorough knowledge of the differences and overlap in clinical presentation among gluten-related disorders, and between them and other gastrointestinal disorders, will help clinicians in the process of differential diagnosis. © The Author(s) 2015.
De Martinis M.,University of L'Aquila |
De Martinis M.,Allergology and Clinical Immunology Unit |
Ciccarelli F.,University of L'Aquila |
Ciccarelli F.,Allergology and Clinical Immunology Unit |
And 4 more authors.
Expert Review of Clinical Immunology | Year: 2016
Systemic sclerosis (SSc) is a connective tissue disease with a complex and multifactorial pathogenesis, characterized by excessive collagen deposition and vasculopathy, leading to skin fibrosis and involvement of internal organs. Regarding the aetiology of SSc, our current knowledge is still limited; however, as for other autoimmune syndromes, the disease is probably caused by both endogenous and exogenous factors. Among the exogenous factors, in the past decades, several environmental exposures, including occupational exposure to pollutants, chemicals and hand-arm vibrations as well as infections, silicone and use of drugs, have been suggested to play a role in the development of SSc. The following review analyzes the most recent literature to examine the relationship between environmental exposures and SSc. © 2016 Taylor & Francis.