Dear Marla,
Thanks for alerting us to the issue of Pediatrics. I found some of the
information interesting. I was, however, quite bothered by the fact that
they lumped celiac under the "allergy' and that they did not seem to be up
to date on many of the diagnostic tools available today. My husband has
celiac disease. I and my brother have a casein autoimmunity. Both will not
be seen on an IgE test as they aren't  not allergies mediated by mast
cells. They are more to be understood as other autoimmune diseases such as
juvenile diabetes.  Celiac is detected by IgA and IgG antibodies. In the
case of celiac also by tissue transglutamanese tests. In addition, celiac
risk can be determined by genetic tests. Current research studies indicated
that 1/122 people who appear health may have celiac disease and 1/56 with
 symptoms may have celiac disease. This can be even higher with other risk
factors considered. The gold standard for diagnosis of celiac is an
endoscopy which will find destruction of the villi of the small intestine.
This is now not done in all cases if the tests are all positive.

Tests are usually handled by the gastroenterologist and not  by allergists,
who, judging from the articles, are not keeping up with the literature at
all. Recent research has been published in the Archives of Internal
Medicine and the New England Journal of Medicine. This is not to minimize
the effects of real allergies, but to clarify that digestive problems which
do not present in the manner of classic allergies should be evaluated by a
well trained gastroenterologist or a pediatric gastroenterologist.
University of Chicago,  University of Maryland at Baltimore and Columbia
Presbyterian all have celiac centers. Celiac can have many serious effects
on children including causing seizures.

Irma De Bruyn, M. Ed.
Licensed Educational Psychologist
Nationally Certified School Psychologist
( recently retired from the Norwood Public Schools)



-----Original Message-----
From:   Marla Shapiro [SMTP:[log in to unmask]]
Sent:   Monday, June 23, 2003 12:28 PM
To:     [log in to unmask]
Subject:        great info

hi, y'all....

the June 2003 supplement to the professional journal Pediatrics (Vol. 111 =
Issue sup 1) consists of what looks like a fabulous series of articles on =
food allergies. even tho it's geared towards professionals & pediatrics, =
looks like the articles might be helpful to all of us.

there are a number of articles on  topics near & dear to our hearts like: =
mucosal immunity, anaphylaxis & emergency treatment, clinical aspects of =
gastrointestinal food allergy (FA), skin manifestations of FA, respiratory
=
manifestations of FA, natural history of FA, diagnostic evaluations, =
nutritional management, FA avoidance, & future approaches.

HTH,
marla

Marla Shapiro, Ph.D.
MSC 5A0622
Regents Center for Learning Disorders
Georgia State University
33 Gilmer Street SE, Unit 5
Atlanta, GA 30303-3085