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Subject:
From:
Tim Morck <[log in to unmask]>
Date:
Thu, 4 Mar 1999 21:26:01 -0800
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<<Disclaimer: Verify this information before applying it to your situation.>>

A request was posted today for any recent scientific articles on celiac
disease that addressed the cellular and biochemical aspects.  I just
received my March issue of The American Journal of Clinical Nutrition
and was delighted to see that it contains an excellent review  by Dr.
Joseph Murray of The Mayo Clinic.  It might not be in your local medical
library yet, but should be within a week or two.  Often community
libraries can obtain photocopies through interlibrary loan.  Here is the
full reference:

Murray, Joseph A. The widening spectrum of celiac disease.  Am J Clin
Nutr 1999;69:354-65.

While that's the technical citation, in common language it means Volume
69, pages 354 through 365 and is the March 1999 issue.  It would be good
to share this with your physician, whether he/she is in Family Practice,
General Internal Medicine, Gastroenterology, or any generalist or
specialist you have contact with.  Dr. Murray has written this in such a
way that will be understood by most people with celiac disease, since
you have already learned much of the vocabulary relevant to the
condition.  He covers it in sufficient depth, however, to also promote a
better understanding within the medical community.  You now have an
opportunity to participate in your doctor's "continuing medical
education" by sharing the reference or article.  Here are the major
headings in the review (CD=3DCeliac Disease):

Introduction
Pathophysiology (including genetics, environmental, immunologic, and
trigger factors, cellular and humoral immunity)
Clinical Presentation (with a nice table on GI and nonGI symptoms that
should suggest looking for CD)
Epidemiology
Diagnosis of CD
Dermatitis Herpetiformis (and its association with CD)
Screening Tests for CD (Biopsies, gluten challenge, serologic tests and
their clinical utility)
Treatment of CD (dietary management - gluten free diet, persistent
diarrhea, refractory CD, malignancy and CD)
The Future of CD
(there are 121 references cited to substantiate his comments)
This is an excellent, up-to-the-minute status report on what is known,
and what still needs to be better understood, about celiac disease from
all of its medical dimensions.  What is missing is the human element,
and the challenges and triumphs of living and enjoying life despite
having a serious disease.  But that's what many of the other postings to
this site portray.  As a non-celiac nutrition scientist, I commend you
all for your passion, your unconquerable spirit, and strong sense of
community.  Perhaps that should be highlighted in a future article.

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