...use only. How I treat How I treat enteropathy-associated T-cell lymphoma Antonio Di Sabatino,1 Federico Biagi,1 Paolo G. Gobbi,1 and Gino R. Corazza1 1First Department of Medicine, Centro per lo Studio e la Cura della Malattia Celiaca, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico S. Matteo, University of Pavia, Pavia, Italy Enteropathy-associated T-cell lymphoma (EATL) is a complication of celiac disease (CD). This tumor derives from the neoplastic transformation of aberrant intraepithelial T lymphocytes emerging in celiac patients unresponsive to a gluten-free diet. Poor adherence to a gluten-free diet, HLA-DQ2 homozygosity, and late diagnosis of CD are recognized as risk factors for malignant evolution of CD. Recurrence of diarrhea, unexplained weight loss, abdominal pain, fever, and night sweating should alert physicians to this complication. The suspicion of EATL should lead to an extensive diagnostic workup in which magnetic resonance enteroclysis, positron emission tomography scan, and histologic identification of lesions represent the best options. Treatment includes high-dose chemotherapy preceded by surgical resection and followed by autologous stem cell transplantation, although biologic therapies seem to be promising. Strict adherence to a gluten-free diet remains the only way to prevent EATL. (Blood. 2012;119(11): 2458-2468) Introduction Celiac disease (CD) is a chronic gluten-sensitive enteropathy characterized by a high prevalence...
Words: 9183 - Pages: 37
...interrupt a normal, life style to where most of us take for granted. Have you ever wondered what life would be like if you found out you could not eat normal everyday foods that most of us take for granted? What if one day you woke up and found out you could not eat something as simple and as popular as pizza? That you could not eat bread, cake, cookies, lasagna, spaghetti, or even drink beer? That every time you did, you would get sick. Well, for a growing percentage of Americans, that is what is becoming a reality. What is it? How do you get it? What does it do to you? Who can get it? These are just some of the questions I will be answering in this paper. What is Celiac Disease? Well that’s a very good question. Celiac Disease or Gluten-Sensitive Enteropathy is a disease of the intestinal tract. It is a chronic tropical disease of intestinal malabsorption or in simple terms, an allergy to wheat products such as wheat, rye, barley, and oats (Reilly 116). Celiac Disease is a lifelong disease that can only be controlled by understanding CD and following a lifelong diet which excludes wheat, barley, and rye. Celiac Disease is a multisystem disorder that causes the body’s immune system to respond to proteins in certain grains which damage the small intestine. The wheat-type grain that has the protein gliadin (gives elastic properties to flour) is harmful to those who have CD. Barley-type grains have hordein (is a glycoprotein) and rye has secalin (a protein in rye). The chemical make-up...
Words: 1567 - Pages: 7
...50 Celiac Disease Dascha C. Weir, MD Ciaran Kelly, MD Celiac disease (CD) is an immune-mediated enteropathy secondary to permanent sensitivity to wheat gluten and related proteins in rye and barley. It results in characteristic histologic changes consisting of inflammation, crypt hyperplasia, and villous atrophy of the small intestine in genetically susceptible individuals. Significant variability in the clinical presentation of CD in the pediatric population complicates recognition of the disease in many patients. Treatment for CD consists of a lifelong strict gluten-free diet (GFD). Adherence to this diet is associated with resolution of most related signs and symptoms and a decreased risk of related complications. With an explosion of new knowledge over the span of two decades, our understanding of CD has changed dramatically. CD has gone from a rare condition causing gastrointestinal symptoms in children of European origin to a common disorder causing symptoms that affect multiple organ systems in all ages virtually worldwide.1 The overall prevalence of CD is similar in Europe and North America affecting up to 1% of the population.2,3 A large multicenter study in the United States, using serologic screening with biopsy confirmation to identify cases of CD, showed a prevalence of CD of 1:133 in individuals with no evident risk factors. Prevalence of CD in symptomatic patients was 1:56. The prevalence of diagnosed CD is much lower, especially in the...
Words: 8749 - Pages: 35
...Food Allergens An allergy is used to describe a response, within the body, to a substance, which is not necessarily harmful in itself, but results in an immune response and a reaction that causes symptoms and disease in a predisposed person. All food allergies are caused by an immune system malfunction. The immune system identifies certain proteins as harmful, triggering the production of immunoglobulin E (IgE) antibodies to neutralize the proteins known as allergens. Allergens are organic compound that contain hydrogen, oxygen and nitrogen, which form an important part of living organisms. Allergens contain protein, which is often regarded as a constituent of the food that we eat. For these to cause an allergic response they need to be bound to a protein once they are in the body. An allergic person’s immune system believes allergens to be damaging and so produces a special type of antibody (IgE) to attack the invading material. This leads to other blood cells to release further chemicals (including histamine), which together cause the symptoms of an allergic reaction. The most common symptoms are: sneezing, runny nose, itchy eyes and ears, severe wheezing, coughing, shortness of breath, sinus problems, a sore palate, swelling, sickness, vomiting, diarrhea and nettle-like rash.Almost anything can be an allergen for someone, but the most common are: wheat, soy, milk, eggs, nuts, tree nuts, fish, shellfish and other, like sulfites, which are food intolerances and...
Words: 5096 - Pages: 21
...1. Congenital rubella: a) Has an incubation period of 7-10 days. b) May be complicated by polyarthralgia. c) Rarely causes deafness. d) Is an indication for termination if it occurs in the first two months of pregnancy. e) May cause prolonged jaundice. 2. Recognised causes of delayed bone age include: a) Hypopiturtarism b) Primary hypothyroidism c) Congenital adrenal hypoplasia d) Prolonged corticosteroid therapy e) Tuberculosis 3. Kwashiorkor: a) Hypothermia is a recognized complication T b) Edema is mainly due to protein losing enteropathy. T c) Measles is a recognized precipitant F d) The incidence is highest in the first two month of life F e) The birth of a second child to the mother may be a contributory factor F 4. At the age of eight months a baby can be expected to: a) Roll over from front to back T b) Sit up with a straight back T c) Pick a small bead between thumb and finger T d) Say up to five word clearly F e) Feed himself with a spoon F 5. if a child in the ward's develops measles, the following action are appropriate a) Close the wards to all admissions for one week F b) Actively immunized all the other patients against measles T c) Give gamma globulin to all patients who have not been immunized or had measles T d) Forbid visiting by the parents until the rash has gone F e) Give prophylactic antibiotics to all contacts at home T 6. Convulsion in the first week of life is characteristic of a) Hypocalcaemia T b) Post maturity...
Words: 12009 - Pages: 49
...publisher. No patent liability is assumed with respect to the use of the information contained herein. Although every precaution has been taken in the preparation of this book, the publisher and author assume no responsibility for errors or omissions. Nor is any liability assumed for damages resulting from the use of the information contained herein. ISBN-13:978-0-7897-2706-9 ISBN-10: 0-7897-3706-x Library of Congress Cataloging-in-Publication Data Rinehart, Wilda. NCLEX-PN exam cram / Wilda Rinehart, Diann Sloan, Clara Hurd. -- 2nd ed. p. cm. ISBN 978-0-7897-3706-9 (pbk. w/cd) 1. Practical nursing--Examinations, questions, etc. 2. Nursing--Examinations, questions, etc. 3. National Council Licensure Examination for Practical/Vocational Nurses--Study guides. I. Sloan, Diann. II. Hurd, Clara. III. Title. RT62.R55 2008 610.73'076--dc22 2008000133 Printed in the United States of America First Printing: February 2008 Trademarks All terms mentioned in this book that are known to be trademarks or service marks have been appropriately capitalized. Pearson Education cannot attest to the accuracy of this information. Use of a term in this book should not be regarded as affecting the validity of any trademark or service mark. Warning and Disclaimer Every effort has been made to make this book as complete and as accurate as possible, but no warranty or fitness is implied. The information provided is on an “as is” basis. The...
Words: 177674 - Pages: 711
