1
|
Tamai T, Ihara K. Celiac Disease Genetics, Pathogenesis, and Standard Therapy for Japanese Patients. Int J Mol Sci 2023; 24:ijms24032075. [PMID: 36768398 PMCID: PMC9916540 DOI: 10.3390/ijms24032075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/14/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023] Open
Abstract
Celiac disease is an autoimmune disease primarily affecting the small intestine that is caused by the ingestion of gluten in genetically susceptible individuals. The development of celiac disease is based on a complex immune response to gluten proteins. The global average prevalence in the general population is about 1%. In recent years, it has become clear that celiac disease is not less common in Asian countries than in Western countries but often remains undiagnosed. Although the number of patients with celiac disease in Asia is expected to increase with improving disease recognition and advances in diagnostic techniques, there remain few reports of celiac disease in the Far East region of Asia, especially in Japan. In this paper, we outline the epidemiology, diagnosis, and treatment of celiac disease. In addition, we summarize the reported Japanese cases of celiac disease with an overview in Japan.
Collapse
|
2
|
Kaneko S, Matsuda K, Mizuta Y, Shiratori S, Kishi K, Nakamura A, Yagisawa M, Ehira N, Uebayashi M, Kobayashi H. Severe spruelike enteropathy and collagenous colitis caused by olmesartan. BMC Gastroenterol 2021; 21:350. [PMID: 34556042 PMCID: PMC8461977 DOI: 10.1186/s12876-021-01926-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 09/14/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Olmesartan, which is an angiotensin II receptor blocker, reportedly causes spruelike enteropathy, with intestinal villous atrophy as its typical histopathological finding. Interestingly, collagenous and/or lymphocytic gastritis and colitis occur in some patients. We report the case of a 73-year-old Japanese man with a 2-month clinical history of severe diarrhea and weight loss. There were few reports in which spruelike enteropathy and collagenous colitis were both observed and could be followed up. CASE PRESENTATION We report a case of a 73-year-old man with a 2-month clinical history of severe diarrhea and weight loss. He had taken olmesartan for hypertension treatment for 5 years. Endoscopic examination with biopsies revealed intestinal villous atrophy and collagenous colitis. Suspecting enteropathy caused by olmesartan, which was discontinued on admission because of hypotension, we continued to stop the drug. Within 3 weeks after olmesartan discontinuation, his clinical symptoms improved. After 3 months, follow-up endoscopy showed improvement of villous atrophy but not of the thickened collagen band of the colon. However, the mucosa normalized after 6 months, histologically confirming that the preexistent pathology was finally resolved. CONCLUSIONS This report presents a case in which spruelike enteropathy and collagenous colitis were both observed and could be followed up. In unexplained cases of diarrhea, medication history should be reconfirmed and this disease should be considered a differential diagnosis.
Collapse
Affiliation(s)
- Shiho Kaneko
- Depertment of Gastroenterology, Kitami Red Cross Hospital, Higashi-2, Kita-6, Kitami, 090-0026, Japan
| | - Kana Matsuda
- Depertment of Gastroenterology, Kitami Red Cross Hospital, Higashi-2, Kita-6, Kitami, 090-0026, Japan.
| | - Yasuko Mizuta
- Depertment of Gastroenterology, Kitami Red Cross Hospital, Higashi-2, Kita-6, Kitami, 090-0026, Japan
| | - Shoya Shiratori
- Depertment of Gastroenterology, Kitami Red Cross Hospital, Higashi-2, Kita-6, Kitami, 090-0026, Japan
| | - Kazuma Kishi
- Depertment of Gastroenterology, Kitami Red Cross Hospital, Higashi-2, Kita-6, Kitami, 090-0026, Japan
| | - Akihisa Nakamura
- Depertment of Gastroenterology, Kitami Red Cross Hospital, Higashi-2, Kita-6, Kitami, 090-0026, Japan
| | - Masataka Yagisawa
- Depertment of Gastroenterology, Kitami Red Cross Hospital, Higashi-2, Kita-6, Kitami, 090-0026, Japan
| | - Nobuyuki Ehira
- Depertment of Gastroenterology, Kitami Red Cross Hospital, Higashi-2, Kita-6, Kitami, 090-0026, Japan
| | - Minoru Uebayashi
- Depertment of Gastroenterology, Kitami Red Cross Hospital, Higashi-2, Kita-6, Kitami, 090-0026, Japan
| | - Hiroya Kobayashi
- Department of Pathology, Asahikawa Medical University, 1-1 Midorigaoka Higashi-2 Hokkaido, Asahikawa, Japan
| |
Collapse
|