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. 1985 Oct;54(2):140–147.

Clinical presentation of coeliac disease in adult gastroenterological practice

S Boyd, B J Collins, P M Bell, A H G Love
PMCID: PMC2448135  PMID: 4095802

Abstract

Clinical features, complications and results of investigations are analysed in 50 patients diagnosed by jejunal biopsy as having coeliac disease at the Adult Gastroenterology Unit, Royal Victoria Hospital, Belfast, between 1969 and 1983. Only one patient was entirely asymptomatic, but 22% had no disturbance of bowel habit, and 50% had not lost weight. There were relatively few physical abnormalities on clinical examination. Screening tests using standard haematological and biochemical methods were positive only in between 8% and 52% of patients. More specific tests for malabsorption were positive in between 54% and 84% of patients. Jejunal biopsy remains the definitive procedure to identify patients with coeliac disease.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ADLERSBERG D., WANG C. I., BOSSAK E. T. Disturbances in protein and lipid metabolism in malabsorption syndrome. J Mt Sinai Hosp N Y. 1957 May-Jun;24(3):206–220. [PubMed] [Google Scholar]
  2. BENSON G. D., KOWLESSAR O. D., SLEISENGER M. H. ADULT CELIAC DISEASE WITH EMPHASIS UPON RESPONSE TO THE GLUTEN-FREE DIET. Medicine (Baltimore) 1964 Jan;43:1–40. doi: 10.1097/00005792-196401000-00001. [DOI] [PubMed] [Google Scholar]
  3. COOKE W. T., PEENEY A. L. P., HAWKINS C. F. Symptoms, signs and diagnostic features of idiopathic steatorrhoea. Q J Med. 1953 Jan;22(85):59–78. [PubMed] [Google Scholar]
  4. Collins J. S., Porter K. G. Rapid jejunal biopsy without radiological screening. Ir J Med Sci. 1984 Nov;153(11):392–393. doi: 10.1007/BF02939803. [DOI] [PubMed] [Google Scholar]
  5. Croese J., Harris O., Bain B. Coeliac disease. Haematological features, and delay in diagnosis. Med J Aust. 1979 Oct 6;2(7):335–338. [PubMed] [Google Scholar]
  6. FINLAY J. M., WIGHTMAN K. J. The xylose tolerance test as a measure of the intestinal absorption of carbohydrate in sprue. Ann Intern Med. 1958 Dec;49(6):1332–1347. doi: 10.7326/0003-4819-49-6-1332. [DOI] [PubMed] [Google Scholar]
  7. FOWLER D., COOKE W. T. Diagnostic significance of d-xylose excretion test. Gut. 1960 Mar;1:67–70. doi: 10.1136/gut.1.1.67. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. GARDNER F. H., SANTIAGO E. P. Oral absorption tolerance tests in tropical sprue. AMA Arch Intern Med. 1956 Oct;98(4):467–474. doi: 10.1001/archinte.1956.00250280069009. [DOI] [PubMed] [Google Scholar]
  9. Hallert C., Tobiasson P., Walan A. Serum folate determinations in tracing adult coeliacs. Scand J Gastroenterol. 1981;16(2):263–267. doi: 10.3109/00365528109181966. [DOI] [PubMed] [Google Scholar]
  10. Kilander A. F., Dotevall G., Fällström S. P., Gillberg R. E., Nilsson L. A., Tarkowski A. Evaluation of gliadin antibodies for detection of coeliac disease. Scand J Gastroenterol. 1983 May;18(3):377–383. doi: 10.3109/00365528309181610. [DOI] [PubMed] [Google Scholar]
  11. Kilander A. F., Dotevall G., Lindstedt G., Lundberg P. A. Plasma enteroglucagon related to malabsorption in coeliac disease. Gut. 1984 Jun;25(6):629–635. doi: 10.1136/gut.25.6.629. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Krawitt E. L., Beeken W. L. Limitations of the usefulness of the d-xylose absorption test. Am J Clin Pathol. 1975 Feb;63(2):261–263. doi: 10.1093/ajcp/63.2.261. [DOI] [PubMed] [Google Scholar]
  13. MCIVER C. Gluten-free diet in idiopathic steatorrhoea: report of a case. Lancet. 1952 Dec 6;2(6745):1112–1114. doi: 10.1016/s0140-6736(52)90944-6. [DOI] [PubMed] [Google Scholar]
  14. Newcomer A. D., Hofmann A. F., DiMagno E. P., Thomas P. J., Carlson G. L. Triolein breath test: a sensitive and specific test for fat malabsorption. Gastroenterology. 1979 Jan;76(1):6–13. [PubMed] [Google Scholar]
  15. RINALDO J. A., Jr, GLUCKMANN R. F. MAXIMAL ABSORPTION CAPACITY FOR XYLOSE IN NONTROPICAL SPRUCE. Gastroenterology. 1964 Sep;47:248–250. [PubMed] [Google Scholar]
  16. Sladen G. E., Kumar P. J. Is the xylose test still a worth-while investigation? Br Med J. 1973 Jul 28;3(5873):223–226. doi: 10.1136/bmj.3.5873.223. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Tomkin G. H., Bell T. K., Hadden D. R. Evaluation of malabsorption test using 14 C triglyceride. Ir J Med Sci. 1971 Oct;140(10):449–454. doi: 10.1007/BF02940114. [DOI] [PubMed] [Google Scholar]

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