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Subject:
From:
Mary Garrard <[log in to unmask]>
Reply To:
Mary Garrard <[log in to unmask]>
Date:
Fri, 21 Mar 2008 14:40:48 -0700
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<<Disclaimer: Verify this information before applying it to your situation.>>

Hello, thanks to everyone for their responses. Sorry I didn't get to reply personally to you all. 

Many knew of someone elderly who was diagnosed. All agreed it is worth it if an elderly person gets diagnosed and their health usually improves on a gluten free diet. Some found older relatives or friends to have a harder time following the diet for various reasons, but those that did, did very well on it. Some had a diagnosis by eliminating gluten from the diet and noticing improvement in their symptoms. A number mentioned that because of the age-related decrease in immune function, blood tests may be less accurate in the elderly. One person sent this abstract.

  Lurie Y,  Landau DA,  Pfeffer J,  Oren R. 
Celiac disease diagnosed in the elderly. J Clin Gastroenterol. 2008 Jan;42(1):59-61.


  
   Liver Disease Unit, Gastroenterology Institue, Tel-Aviv Sorasky Medical Center, Tel Aviv, Israel. [log in to unmask]

  
   BACKGROUND AND AIMS: In the past 20 years, a growing proportion of new cases of celiac disease (CD) are diagnosed in adults and in patients with extraintestinal manifestations. Our understanding of the extremely wide spectra of manifestations and the profound effects on elderly patients is improving. Nevertheless, CD is still underdiagnosed in elderly patients. In this study, we describe a case series of CD patients diagnosed after the age of 60. METHODS: A retrospective chart review was preformed in cases of CD diagnosed after the age of 60. Patients were included if they had positive serology and histologic findings compatible with CD. Eligible patients were reinterviewed, and demographic, clinical, and laboratory information were recorded. RESULTS: During the study period, 7 patients with CD diagnosed after the age of 60 were identified. The most common presenting findings were weight loss, iron deficiency anemia, and diarrhea. Two patients suffered from severe early
 osteoperosis and 2 additional patients had elevated liver function tests. Neurologic manifestation was suspected in 3 cases. Two female patients presented with cognitive decline that was attributed to Alzheimer dementia but ameliorated after the initiation of gluten-free diet. The third patient had peripheral neuropathy that completely resolved after the initiation of gluten-free diet. Median lag in diagnosis was 8 years. Diet treatment led to complete resolution of symptoms in most cases and a significant weight gain (median 7.75 kg, range 5 to 11). One patient developed a fatal intestinal T-cell lymphoma. CONCLUSIONS: In this case series, we have described several cases of CD in patients over the age of 60 with a varied spectrum of manifestations. We have also found a significant lag in diagnosis and treatment. We believe that it is important to promote the identification of CD as a possible culprit in varied clinical conditions in the elderly population. I recently
 spoke with Dr. Fasano of UMB on this topic, suggesting that a survey of nursing homes should be made for celiac disease, with the thinking that since celiac is a debilitating disease that there might be a higher proportion of people in nursing homes than in the general population of elderly who may more likely be able bodied.  He said that he was working on it!  Should be interesting.


Again thanks to all who replied.
 
       
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