Summary of the Article
Objectively, the article talks about the celiac disease, a complication associated with the inflammation of the small intestines characterized by ingestion of gluten. It describes the relationship between the celiac disease and the endocrine autoimmunity. Therefore, people at higher risks of attack by the celiac disease are those who have either monoglandular or polyglandular autoimmunity based on specific genetic backgrounds. Again, the article cites that those with autoimmune thyroid and type 1 diabetes are highly prevalent to the celiac disease (CeD). It implies that a gluten-free diet has no negative impacts regarding the reverse of the glandular autoimmunity.
The study design involved a randomized dietary intervention among infants in the context of a specific group at higher risks of contracting the CeD. Again, the research design encompassed the screening and diagnosis of patients with type 1 diabetes to determine if they had the CeD and autoimmune thyroid disease. The outcomes of the study were crucial in making crucial recommendations regarding how to prevent the CeD and the glandular autoimmunity through consumption of gluten-free foods. Therefore, the diagnostic tests confirm that type 1 diabetes increases the prevalence chances of having the CeD and the recognition of either IgA or IgG autoantibodies is the fundamental detectives during screening.
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Ideally, people with the celiac disease are highly prevalent to glandular autoimmune disorders. However, some research evidences have also proved that the Hashimoto’s thyroiditis and the Graves’ disease also contribute to the increased risks of having the CeD. The type 1 diabetes is common in individuals with higher susceptibility to genetic complications as in the case of interference with insulin-producing β-cells. Subjectively, I like the manner in which the article addresses the concept of reducing the prevalence rates to autoimmune diseases if children stick to gluten-free diets. In this regard, the article further suggests an early diagnosis of the CeD to reduce prevalence rates to AITD and type 1 diabetes in children.
Case Report of a Patient with Celiac Disease and Gluten Intolerance
A 26-year old lady reported to my office and explained that she was infertile; and had visited a gynecologists a couple of years ago for her condition. They tried to have a child after 2 years of an eight-year-old marriage, but all their efforts ended up in vain. She claimed that she had never used any OPC or IUD at any point in her life and that she always had a normal menstrual cycle, with the first menarche occurring when she was 14. Her past medical history showed no signs and symptoms of neurologic diseases including anxiety and depression, and her clinical history and abdominal surgery were negative. However, the patient proved that there was hypothyroidism, diabetes in her mother and aunt’s medical history. Furthermore, her BMI was 23, which is very normal and the secondary sexual characteristics were similarly usual. Finally, I decided to critically evaluate her partner, who showed a very usual male factor and spermogram.
The patient carried with her, laboratory results of the post-coital test (PCT) and hisrosalpangography. I analyzed the results and found that they were very normal. Therefore, I ordered a diagnostic laparoscropy. This test showed negative tubal endometriosis. However, the patient also complained of an earlier diagnosis when she had diarrhea and lost exactly 3kg of her weight. The lab findings, which she presented in person, confirmed that she had iron deficiency and intestinal signs that suggested 4 years of infertility. Such positive results proved that she had the celiac disease. These were proved by the total IgA greater than 40, and her tTG was also greater than 30. Analysis of the GI endoscopy and biopsy of the latter part of the duodenum showed that she had severe malabsorption with her villi flattening. Hence, these factors outstandingly represent the etiological manifestations of the CeD. However, the pathophysiological manifestations are environmentally triggered by gluten, that later causes enterocyte destruction and eventually villous atrophy. Therefore, I suggested that she should stick to a non-gluten diet to reduce the overexpression of the IL-15 in her intestines; and eventually reduce the pathogenesis of the celiac disease.
