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Trynka G, Zhernakova A, Romanos J, Franke L, Hunt KA, Turner G, Bruinenberg M, Heap GA, Platteel M, Ryan AW, de Kovel C, Holmes GKT, Howdle PD, Walters JRF, Sanders DS, Mulder CJJ, Mearin ML, Verbeek WHM, Trimble V, Stevens FM, Kelleher D, Barisani D, Bardella MT, McManus R, van Heel DA, Wijmenga C. Coeliac disease-associated risk variants in TNFAIP3 and REL implicate altered NF-kappaB signalling. Gut 2009; 58:1078-83. [PMID: 19240061 DOI: 10.1136/gut.2008.169052] [Citation(s) in RCA: 157] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Our previous coeliac disease genome-wide association study (GWAS) implicated risk variants in the human leucocyte antigen (HLA) region and eight novel risk regions. To identify more coeliac disease loci, we selected 458 single nucleotide polymorphisms (SNPs) that showed more modest association in the GWAS for genotyping and analysis in four independent cohorts. DESIGN 458 SNPs were assayed in 1682 cases and 3258 controls from three populations (UK, Irish and Dutch). We combined the results with the original GWAS cohort (767 UK cases and 1422 controls); six SNPs showed association with p<1 x 10(-04) and were then genotyped in an independent Italian coeliac cohort (538 cases and 593 controls). RESULTS We identified two novel coeliac disease risk regions: 6q23.3 (OLIG3-TNFAIP3) and 2p16.1 (REL), both of which reached genome-wide significance in the combined analysis of all 2987 cases and 5273 controls (rs2327832 p = 1.3 x 10(-08), and rs842647 p = 5.2 x 10(-07)). We investigated the expression of these genes in the RNA isolated from biopsies and from whole blood RNA. We did not observe any changes in gene expression, nor in the correlation of genotype with gene expression. CONCLUSIONS Both TNFAIP3 (A20, at the protein level) and REL are key mediators in the nuclear factor kappa B (NF-kappaB) inflammatory signalling pathway. For the first time, a role for primary heritable variation in this important biological pathway predisposing to coeliac disease has been identified. Currently, the HLA risk factors and the 10 established non-HLA risk factors explain approximately 40% of the heritability of coeliac disease.
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Affiliation(s)
- G Trynka
- Genetics Department, University Medical Centre, University of Groningen, Groningen, The Netherlands
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Brophy K, Ryan AW, Thornton JM, Abuzakouk M, Fitzgerald AP, McLoughlin RM, O'morain C, Kennedy NP, Stevens FM, Feighery C, Kelleher D, McManus R. Haplotypes in the CTLA4 region are associated with coeliac disease in the Irish population. Genes Immun 2005; 7:19-26. [PMID: 16237465 DOI: 10.1038/sj.gene.6364265] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Chromosomal region 2q33 encodes the immune regulatory genes, CTLA4, ICOS and CD28, which are involved in regulation of T-cell activity and has been studied as a candidate gene locus in autoimmune diseases, including coeliac disease (CD). We have investigated whether an association exists between this region and CD in the Irish population using a comprehensive analysis for genetic variation. Using a haplotype-tagging approach, this gene cluster was investigated for disease association in a case-control study comprising 394 CD patients and 421 ethnically matched healthy controls. Several SNPs, including CTLA4_CT60, showed association with disease; however, after correction for multiple-testing, CTLA4-658C/T was the only polymorphism found to show significant association with disease when allele, genotype, or carrier status frequency were analysed (carrier status (Allele C), P = 0.0016). Haplotype analysis revealed a haplotype incorporating the CD28/CTLA4 and two 5' ICOS polymorphisms to be significantly associated with disease (patients 24.1%; controls 31.5%; P = 0.035), as was a shorter haplotype composed of the CTLA4 markers only (30.9 vs 34.9%; P = 0.042). The extended haplotype incorporating CD28/CTLA4 and 5' ICOS is more strongly associated with disease than haplotypes of individual genes. This suggests a causal variant associated with this haplotype may be associated with disease in this population.
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Affiliation(s)
- K Brophy
- Department of Clinical Medicine, Trinity College, Trinity Centre for Health Sciences, St James's Hospital, Dublin, Ireland
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Ryan AW, Thornton JM, Brophy K, Daly JS, McLoughlin RM, O'Morain C, Abuzakouk M, Kennedy NP, Stevens FM, Feighery C, Kelleher D, McManus R. Chromosome 5q candidate genes in coeliac disease: Genetic variation at IL4, IL5, IL9, IL13, IL17B and NR3C1. ACTA ACUST UNITED AC 2005; 65:150-5. [PMID: 15713213 DOI: 10.1111/j.1399-0039.2005.00354.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Genetic predisposition to coeliac disease (CD) is determined primarily by alleles at the HLA-DQB locus, and evidence exists implicating other major histocompatibility complex-linked genes (6p21) and the CTLA4 locus on chromosome 2q33. In addition, extensive family studies have provided strong, reproducible evidence for a susceptibility locus on chromosome 5q (CELIAC2). However, the gene responsible has not been identified. We have assayed genetic variation at the IL4, IL5, IL9, IL13, IL17B and NR3C1 (GR) loci, all of which are present on chromosome 5q and have potential or demonstrated involvement in autoimmune and/or inflammatory disease, in a sample of 409 CD cases and 355 controls. Thirteen single nucleotide polymorphisms were chosen on the basis of functional relevance, prior disease association and, where possible, prior knowledge of the haplotype variation present in European populations. There were no statistically significant allele or haplotype frequency differences between cases and controls. Therefore, these results provide no evidence that these loci are associated with CD in this sample population.
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Affiliation(s)
- A W Ryan
- Department of Clinical Medicine, Trinity College, Trinity Centre for Health Sciences, St James's Hospital, Dublin 8, Ireland
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Ryan AW, Thornton JM, Brophy K, Daly JS, O'Morain C, McLoughlin RM, Kennedy NP, Abuzakouk M, Stevens FM, Feighery C, Kelleher D, McManus R. Haplotype variation at the IBD5/SLC22A4 locus (5q31) in coeliac disease in the Irish population. ACTA ACUST UNITED AC 2004; 64:195-8. [PMID: 15245375 DOI: 10.1111/j.1399-0039.2004.00251.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In addition to the well-established association of coeliac disease (CD) with HLA-DQ (6p21) and possibly CTLA4 (2q33), there is considerable evidence for a susceptibility locus on chromosome 5q, which contains many potential candidates for inflammatory disease, including a cluster of cytokine genes in 5q31. CD cases and controls were genotyped for four single-nucleotide polymorphism (SNP) markers that together characterize >90% of the haplotype variation at the IBD5 locus encoding, among others, the SLC22A4 gene. IBD5 and SLC22A4 map to 5q31 and have recently been associated with Crohn's disease and rheumatoid arthritis. Haplotype frequencies do not differ significantly between CD cases and controls in the Irish population, and therefore the chromosome 5 CD susceptibility locus most likely lies elsewhere on 5q.
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Affiliation(s)
- A W Ryan
- Department of Clinical Medicine, Trinity College, Trinity Center for Health Sciences, St James's Hospital, Dublin, Ireland
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Heneghan MA, Feeley KM, Stevens FM, Little MP, McCarthy CF. Precipitation of iron overload and hereditary hemochromatosis after successful treatment of celiac disease. Am J Gastroenterol 2000; 95:298-300. [PMID: 10638603 DOI: 10.1111/j.1572-0241.2000.01556.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- M A Heneghan
- Department of Medicine and Pathology, Clinical Science Institute, University College Hospital, Galway, Ireland
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Abstract
Levels of secretory IgA1 (SIgA1) in the saliva have not been measured previously in either coeliac disease (CD) or inflammatory bowel disease (IBD). Saliva was collected from coeliacs, IBD patients and controls. The concentration of total SIgA in saliva was measured by enzyme linked immunosorbent assay (ELISA) with an anti-human SIgA antibody as the bound phase and human SIgA isolated from colostrum as the standard. The concentration of SIgA1 was determined using an ELISA with a lectin with a high affinity for human SIgA1. The IBD patients have a significantly higher concentration of SIgA1 than the controls. The rate of secretion of saliva and %SIgA1 was significantly lower in coeliacs than in the control and IBD groups. The rate of secretion of SIgA1 was significantly higher in the IBD than in the coeliacs. We describe hitherto unreported levels of SIgA1 in CD and IBD.
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Affiliation(s)
- R H Warner
- Department of Medicine, University College Hospital, Galway, Ireland
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Abstract
AIMS To investigate the prevalence of lymphocytic gastritis in patients with coeliac disease. METHODS Gastric biopsies from 70 patients with coeliac disease were examined by light microscopy for the presence of lymphocytic gastritis, defined as 25 or more intraepithelial lymphocytes/100 gastric columnar epithelial cells. RESULTS Lymphocytic gastritis was found in seven cases. Positive cases had a mean of 32.1 intraepithelial lymphocytes/100 columnar cells, compared with a mean of 13.9 in negative cases, and 5.15 in noncoeliac controls. No differences were found for age, sex, gastric corpus or antrum, or degree of inflammation in the gastric lamina propria. All intraepithelial lymphocytes were of T cell lineage. Cases not showing lymphocytic gastritis did however show significantly increased gastric intraepithelial lymphocytes compared with non-coeliac controls. Eighteen of 70 cases were positive for Helicobacter pylori, and four of seven cases of lymphocytic gastritis were H pylori positive; no significant difference was observed between H pylori positive and negative patients. Three cases had concomitant ulcerative enteritis, of which none showed lymphocytic gastritis, while five cases had concomitant enteropathy associated T cell lymphoma, of which one showed lymphocytic gastritis. CONCLUSIONS Lymphocytic gastritis occurred in 10% of patients with coeliac disease. Cases without lymphocytic gastritis nevertheless showed increased gastric intraepithelial lymphocytes. Coeliac disease may on occasion be a diffuse lymphocytic enteropathy occurring in response to gluten. Lymphocytic gastritis outside coeliac disease may involve an immune response to luminal antigens, such as H pylori, not unlike the response to gluten in patients with coeliac disease.
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Affiliation(s)
- K M Feeley
- Department of Pathology, University College Hospital, Galway, Ireland
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Clarke G, Ryan E, O’Keane JC, Crowe J, McMathuna P, Moriarty D, Ettarh R, Sheahan K, Hyland J, O’Donoghue DP, Baird AW, Clarke G, Ryan E, Gormley G, Keane JCO, Crowe J, MacMathuna P, Wang JH, Wu QD, Redmond HP, Condron C, Bouchier-Hayes D, Nally K, Newton F, O’Connell J, O’Sullivan GC, Morgan J, Collins JK, Shanahan F, Goode C, O’Connell J, O’Sullivan GC, Collins JK, Shanahan F, Winter DC, Taylor CT, Skelly MM, O’Donoghue DP, O’Sullivan GC, Baird AW, Harvey BJ, Varghese JC, Farrell MA, McGrath FP, Murray FE, Osborne H, Lee MJ, Ryan E, Sullivan A, O’Keane JC, Crowe J, Ryan AE, O’Keane JC, Crowe J, Donovan AN, McCormick PA, Kenny B, Somers S, Bohan A, Gibney RG, Marcaccio M, Malone DE, Doyle M, Delaney CP, Gorey TF, McEntee GP, O’Sullivan GC, Clarke A, Stuart R, Kelly J, Kiely MD, Collins JK, Shanahan F, O’Sullivan M, Lovett E, Mahmud N, Kelleher D, O’Morain CA, Larkin CJ, Watson RGP, Sloan JM, Ardill JES, Johnston CF, Buchanan KD, Heaney A, Collins JSA, Watson GRP, Kalin RM, Heaney A, Collins JSA, Tham TCK, Watson RGP, McFarland RJ, Bamford KB, Cróinín TÓ, Clyne M, Drumm B, Rowland M, Kumar D, O’Connor P, Daly LE, Drumm B, O’Toole DL, Long A, Murphy AM, O’Neill L, Weir DG, Kelleher D, Heaney A, Collins JSA, Watson RGP, Hopkins AM, Moynagh P, O’Donoghue DP, Baird AW, Brennan C, Harmey J, Stapleton PP, Redmond HP, Bouchier-Hayes D, Rasheed AM, Chen G, Kelly C, Bouchier-Hayes DJ, Leahy A, Gallagher M, Grace A, Xin Y, Leader M, Kay E, Whelan A, Pattison U, Willoughby R, Wallace E, Weir D, Feighery C, Bennett MW, O’Connell J, O’Sullivan GC, Brady C, Roche D, Collins JK, Shanahan F, Mahmud N, Molloy A, McPartlin J, Scott JM, Weir DG, Acheson AG, Lee J, Khosraviani K, Irwin ST, McDaid J, McCormick PA, Docherty JR, O’Grady A, Kay E, Mabruk M, Grace A, Leader M, Lee J, Acheson AG, Irwin ST, Larkin CJ, Johnston C, Curry W, Ardill J, Cunningham R, Buchanan KD, Watson RGP, McDougall NI, Coyle PV, Callender ME, Ouinn AM, Warner R, Stevens FM, Chakravarthi PIS, Kearns M, Bourke M, Hassan A, McWeeney J, Stevens FM, McCarthy CF, Casey M, O’Donoghue J, Eustace-Ryan AM, O’Regan P, Feighery L, Jackson J, Cronin N, Shanahan F, Quane K, Feighery C, Mulligan ED, Purcell T, Dunne B, Griffin M, Noonan N, Hollywood D, Keeling N, Reynolds JV, Hennessy TPJ, Mulligan ED, Purcell T, Dunne B, Griffin M, Noonan N, Hollywood D, Keeling N, Reynolds JV, Hennessy TPJ, Mulligan ED, Purcell T, Dunne B, Griffin M, Noonan N, Hollywood D, Keeling N, Reynolds JV, Hennessy TPJ, Mulligan ED, Purcell T, Dunne B, Griffin M, Noonan N, Hollywood D, Keeling N, Reynolds JV, Hennessy TPJ, O’Sulhvan M, Harman I, Breslin NP, Clayton N, O’Morain CA, Hogan S, Donovan B, Hayes D, Kiely M, Eustace-Ryan AM, O’Regan P, Goulding CA, Albloushi SS, O’Connor J, Courtney MG, Murray FE, Albloushi SS, Goulding CA, Kay E, Royston D, Leader M, Courtney MG, Murray FE, Albloushi SS, Kay E, Goulding CA, Grace A, O’Connor J, Shattock AG, Courtney MG, Murray FE, Albloushi SS, Stack A, Kay E, Goulding CA, Carmody M, Murray FE, Courtney MG, Barrett S, Ryan E, O’Keane JC, Crowe J, Hennigan A, Delaney CP, Young L, Shields CJ, O’Keane C, Gorey TF, Fitzpatrick JM, Rasheed AM, Wang JH, Kelly C, Bouchier-Hayes DJ, Leahy A, Doyle MM, Stephens RB, Daly PA, Bennett MW, O’Connell J, O’Sullivan GC, Brady C, Roche D, Collins JK, Shanahan F, Briggs GM, McCrory D, Briggs GM, McCrory D, O’Neill S, O’Grady H, Grant DC, Barry K, Traynor O, Hyland JMP, O’Toole GC, Grant DC, Barry MK, Hyland JMP, Johnston SD, Ritchie CM, Robinson TJ, Johnston SD, Kirby JM, Mackle EM, Robinson TJ, Haider N, Aherne N, McNichol F, Hamilton D, Neary P, Hegarty S, Connor JO, Watson RGK, Drudy D, Alwan A, Fenelon L, O’Farrelly C, Hyland J, Byrne B, Madrigal L, Carton J, Collins C, O’Donoghue D, O’Farrelly C, Gannon N, Hickey A, O’Boyle CA, Byrne R, Albloushi S, Murray F. Irish society of gastroenterology. Ir J Med Sci 1998. [DOI: 10.1007/bf02937896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Stevens FM, Kearns MC, McCarthy CF. Abnormal pancreolauryl tests in coeliac disease: lack of correlation with the degree of intestinal mucosal damage. J Clin Pathol 1997; 50:1001-4. [PMID: 9516881 PMCID: PMC500380 DOI: 10.1136/jcp.50.12.1001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIMS To determine the frequency of abnormal pancreolauryl tests in untreated and treated adults with coeliac disease and to see whether abnormalities in treated coeliac patients correlate with the degree of recovery of intestinal morphology or brush border enzyme activity. METHODS Pancreolauryl tests were performed in a study population of 57 adult coeliac patients (25 on gluten containing diets and 32 on gluten free diets), 59 symptomatic controls, and eight patients with pancreatic disease. Brush border enzyme activity and morphological assessment were performed on small intestinal biopsies in 27 of the treated coeliac patients. RESULTS Forty per cent of untreated coeliac patients and 18% of treated coeliac patients had abnormal tests. In treated coeliac patients, no significant correlation was detected between the pancreolauryl test result and either brush border enzyme activity or morphological parameters. CONCLUSION Abnormal pancreolauryl test results are common in untreated and treated adult coeliac disease patients. Abnormalities in treated coeliac patients do not correlate with the degree of recovery of small intestinal morphology or brush border enzymes.
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Affiliation(s)
- F M Stevens
- Department of Medicine, Clinical Science Institute, University College Hospital, Galway, Ireland
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Abstract
Immunoglobulin deficiency, especially deficiency of IgA, has been described in patients with celiac sprue (CS). Our study was performed in an area of high prevalence of CS to determine the prevalence of immunodeficiency states in patients with CS, to examine their clinical characteristics, response to treatment, and HLA phenotypes compared with a group of age- and sex-matched persons with CS but without immunoglobulin deficiency. Fourteen of 604 patients with CS were identified as being selectively deficient in IgA, whereas one had common variable immunodeficiency. At diagnosis, anemia was present in 8 of 14 IgA-deficient patients compared with 10 of 42 controls (p = 0.047), whereas abdominal pain was more common in controls with CS. Autoimmunity and recurrent infection were more prevalent in the IgA-deficient group. Response to gluten-free diet was similar in both groups in terms of histologic structure and recovery of intestinal brush-border enzyme activity. IgA-deficient participants with CS had no increased risk of associated malignancy or lymphoma. HLA phenotypes were similar in both groups. The prevalences of selective IgA deficiency and common variable immunodeficiency in this series of patients with CS are 2.31 in 100 and 0.16 in 100, respectively. Although this group is unique in character, close follow-up coupled with conscientious compliance with a gluten-free diet, remains the mainstay of treatment for these patients.
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Affiliation(s)
- M A Heneghan
- Department of Medicine, University College Hospital, Galway, Ireland
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Abstract
Coeliac disease is associated with selective IgA deficiency and various autoimmune disorders. An association between Addison's disease and coeliac disease has been documented previously in the literature but never heretofore in coeliac patients with selective IgA deficiency. From a coeliac registry of over 700 biopsy-proven coeliac patients, studied closely over a 25-year period at University College Hospital, Galway, we now report the finding of Addison's disease and selective IgA deficiency in two patients with established coeliac disease. Previous reports of Addison's disease in coeliac patients were sporadic, and it was felt that the association between the two conditions was fortuitous. We now believe that coeliac patients, especially those who are selectively deficient in serum IgA, should be followed up with increased vigilance, as the association between IgA-deficient coeliac patients and Addison's disease is greater than can be explained by chance. Furthermore, we suggest that patients with established Addison's disease may have subclinical coeliac disease and should be screened with anti-reticulin or anti-endomyseal antibodies.
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Affiliation(s)
- M A Heneghan
- University Dept. of Medicine, University College Hospital, Galway, Ireland
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Affiliation(s)
- I Casserly
- Department of Medicine, Clinical Science Institute, University College Hospital, Galway, Ireland
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Zhong F, McCombs CC, Olson JM, Elston RC, Stevens FM, McCarthy CF, Michalski JP. An autosomal screen for genes that predispose to celiac disease in the western counties of Ireland. Nat Genet 1996; 14:329-33. [PMID: 8896565 DOI: 10.1038/ng1196-329] [Citation(s) in RCA: 117] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Celiac disease is a strongly heritable gastrointestinal illness that is an especially important model of the genetically complex multifactorial immune mediated diseases. The HLA component of celiac disease (a specific HLA-DQ heterodimer)is largely established and is relatively uncomplicated, and the environmental component (gluten and related grain storage proteins in the diet) is remarkably well understood. Previous family studies of celiac disease suggested that there is at least one important non-HLA locus. This locus may be a stronger genetic factor than HLA, and it apparently has a recessive mode of inheritance. We used a three step genome screening protocol to identify loci that contribute to celiac disease in the western counties of ireland, a region with the highest prevalence of celiac disease in the world. The most significant of several possible non-HLA loci that we found was on chromosome 6p about 30 cM telomeric from HLA. It has a multipoint maximum lod score of 4.66 (compared with 4.44 for HLA-DQ) and appears to have a recessive mode of inheritance. Our study localizes and provides strong evidence for linkage of at least one non-HLA locus to celiac disease and may serve as a prototype for an efficient approach to screening the human genome for loci that contribute to complex diseases.
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Affiliation(s)
- F Zhong
- Department of Internal Medicine, University of South Alabama, Mobile 36688, USA
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Abstract
BACKGROUND The ability to secrete blood group antigens into body fluids and secretions is controlled by a single gene on chromosome 19. By means of erythrocyte Lewis (Le) antigen phenotype secretor status can be inferred. An increase prevalence of non-secretors of blood group antigens among coeliac patients has recently been described. METHODS Blood was collected from 112 coeliac patients and 103 controls and tested for secretor status. Secretor status was correlated with human leucocyte antigens (HLA) in coeliac patients, thus evaluating a proposed interaction of susceptibility genes--that is, the secretor gene on chromosome 19 and HLA-linked genes on chromosome 6. Case notes for coeliacs were reviewed with regard to clinical outcome. RESULTS Of 112 coeliacs who had either Le(a) or Le(b) antigens, 36 (32%) were non-secretors Le(a+, b-), compared with 27% (28) of 103 disease-free controls (P = 0.313). Recessive Lewis phenotype Le(a-, b-) was found in 9% of coeliacs versus 2% of controls. Prevalence of HLA-A1, B8, DR3, and DQ2 was unrelated to secretor status in coeliac versus patients. An increased prevalence of complications and coeliac-associated abnormalities was found in the non-secreting and recessive coeliac groups. CONCLUSIONS This study shows no firm relationship between the non-secretor state and coeliac disease, nor any difference in the distribution of HLA markers among secretor and non-secretor coeliacs. It is unlikely, therefore, that the secretor gene is the much sought-after second coeliac gene.
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Affiliation(s)
- M A Heneghan
- Dept of Medicine, University College Hospital, Galway, Ireland
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Michalski JP, McCombs CC, Arai T, Elston RC, Cao T, McCarthy CF, Stevens FM. HLA-DR, DQ genotypes of celiac disease patients and healthy subjects from the West of Ireland. Tissue Antigens 1996; 47:127-33. [PMID: 8851726 DOI: 10.1111/j.1399-0039.1996.tb02525.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Celiac disease (CD) has one of the strongest class II HLA associations of any human illness. We used DNA-RFLP typing to study the class II HLA genotypes of celiac disease patients from the West of Ireland, the geographic area with the highest rate of celiac disease in the world. We confirmed the high frequency of HLA-DR3 in this population, and we were also able to demonstrate the additional risk of developing celiac disease imparted by HLA-DR7. This was done by clearly distinguishing DR7,DQ2 haplotypes from DR7,DQ9 haplotypes, and by "subtraction analysis" of haplotype frequencies. As reported in other populations, most of the patients without DR3 were heterozygous for DR7 and DR11 or 12 (DR5), or had DR4. We used PCR-RFLP and direct sequencing of amplified DNA to examine HLA-DR4 subtypes. The frequency of HLA-DR4 was markedly decreased in patients compared with controls (p = 0.000001) and there was a significant alteration of DR4 subtypes of the patients compared with controls (p = 0.0227). Moreover, all of the CD patients (5 of 5) with DR4 had a haplotype associated with the DQB1*0302 allele compared with only 11 of 23 control subjects with DR4. Our results in this population with exceptionally high risk of CD strongly support the DQ heterodimer hypothesis and suggest that the recently described sequence difference between the DQB1*02 alleles of DR3 and DR7 may contribute to a synergistic increased risk when these haplotypes are inherited together. In addition, our findings suggest a role for HLA-DQ in DR4-associated CD.
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Affiliation(s)
- J P Michalski
- Department of Internal Medicine, University of South Alabama, Mobile, USA
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Walsh SV, Egan LJ, Connolly CE, Stevens FM, Egan EL, McCarthy CF. Enteropathy-associated T-cell lymphoma in the West of Ireland: low-frequency of Epstein-Barr virus in these tumors. Mod Pathol 1995; 8:753-7. [PMID: 8539233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The Epstein-Barr virus has been implicated in the etiology of endemic Burkitt's lymphoma, post-transplant lymphoma, large-cell anaplastic CD30 (Ki-1)-positive lymphoma, and in many T-cell lymphomas. A recent report has found Epstein-Barr virus genome in association with 4 of 11 cases (36%) of enteropathy-associated T-cell lymphoma. In a retrospective study, we have characterized 22 consecutive cases of enteropathy-associated T-cell lymphoma from the West of Ireland where celiac disease is endemic. All cases were immunophenotyped with T- and B-cell markers including the anaplastic large-cell lymphoma marker CD30 or Ki-1. Nineteen cases were studied for latent membrane protein expression and 16 for Epstein-Barr virus small RNAs by in situ hybridization using EBER oligonucleotides on routinely processed sections. Only 1 of 16 cases (6%) showed Epstein-Barr virus in tumor cells and no cases stained with latent membrane protein. Eight of 22 cases (36%) including the EBER-positive case were positive for CD30. These results suggest that the Epstein-Barr virus does not commonly play a role in the pathogenesis of enteropathy-associated T-cell lymphoma from this area.
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Affiliation(s)
- S V Walsh
- Department of Histopathology, University College Hospital, Galway, Ireland
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Egan LJ, Walsh SV, Stevens FM, Connolly CE, Egan EL, McCarthy CF. Celiac-associated lymphoma. A single institution experience of 30 cases in the combination chemotherapy era. J Clin Gastroenterol 1995; 21:123-9. [PMID: 8583077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Celiac sprue (CS) is frequently complicated by malignancy, most commonly small intestinal lymphoma. Our study was performed in an area with a high prevalence of CS to define the clinical features, response to treatment, and outcome of this tumor. Of a total of 31 lymphomas complicating CS identified, 30 case records and 24 tumor specimens were reviewed. Overall 1-year survival was 9 of 29 (31%) and 5-year survival 3 of 27 (11%). Seven previously diagnosed celiac patients developed lymphoma; length on gluten-free diet ranged from 12 to 252 months (median 44 months). In this group, presentation was nonspecific, diagnosis difficult, and survival poor (lymphoma diagnosed in life in four of seven, mean survival 2.25 months). Twenty-three patients had CS and lymphoma diagnosed during the same illness. In this group, 14 of 23 presented with a surgical emergency and were treated with tumor resection and chemotherapy. Nine are disease-free and alive or died of another cause after 10-196 months (mean 74 follow-up). Celiac-associated lymphoma is a frequent, difficult to diagnose, and commonly fatal complication of CS. An aggressive diagnostic approach, including laparoscopy, is recommended. Long-term survival can be expected in a significant number of these patients and in our series was almost exclusively confined to those treated with chemotherapy.
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Affiliation(s)
- L J Egan
- Department of Medicine, University College Hospital, Galway, Ireland
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Woods M, O’Donnell LJD, Battistini B, Warner T, Vane J, Fartming MG, Yaqoob J, Wu JJ, Norris LA, Khan MI, Keeling PWN, Maguire D, O’Sullivan G, Harvey B, Curran B, Xin∘ Y, Kay EW, Leader M, Henry K, Crosbie O, Norris S, Costello P, O’Farrelly C, Hegarty J, Kennedy B, Duggan M, Plant R, Kenny-Walsh EK, Cotter P, Whelton MJ, Yaqoob J, Khan MI, Maloney M, Noonan N, Keeling PWN, Buckley M, Hamilton H, Beattie S, O’Morain C, McNamara B, Cuffe J, O’Sullivan G, Harvey B, Barry RA, O’Morain C, Collins DA, O’Sullivan GC, Collins JK, Shanahan F, Skelly MM, Mulcahy HE, Troy A, Connell T, Duggan C, Duffyt MJ, Sheahan K, O’Donoghue DP, Buckley M, Xia HX, Hyde D, O’Morain C, O’Brien MG, Fitzgerald EF, Lee G, Shanahan F, O’Sullivan GC, Hussey AJ, Boyle TJ, Garrihy B, Clinton OP, McAnena OJ, Cuffe J, McNamara B, O’Sulllvan G, Harvey B, Corby H, Donnelly V, O’Herlihy C, O’Connell PR, Deignan T, Kelly J, O’Farrelly C, Breslin NP, MacDonnell C, O’Morain C, O’Keeffe J, Mills K, Srinivasan U, Willoughby R, Feighery C, Twohig B, Gaynor K, O’Regan PF, Duggan S, Redmond HP, McCarthy J, Bouchier-Hayes D, Ma QY, Williamson KE, Rowlands BJ, Tobin A, Pilkington R, O’Donnell M, O’Shea E, Conroy A, Kaminski G, Walsh A, Temperley IJ, Kelleher D, Weir DG, Barry MK, Mulligan ED, Stokes MA, O’Riordain MG, Gorey TF, McGeeney KF, Fitzpatrick JM, Watson RWG, Redmond HP, Wang JH, Campbell F, Bouchier-Hayes D, Bennett D, Kavanagh E, Gorman PO, Twohig B, O’Regan P, Shanahan F, Yassin MMI, McCaigue M, Parks TG, Rowlands BJ, D’Sa AABB, Norris S, Lawlor M, McElwaine S, O’Farrelly C, Hegarty J, Heneghan MA, Kerins M, Goulding J, Egan EL, Stevens FM, McCarthy CF, Quirke M, Eustace-Ryan AM, O’Regan PF, Khan MI, Yaqoob J, Qureshi S, Aziz E, Maree A, Collins S, Browne T, Ahmed S, Sullibhan BO, Smith P, Walker F, O’Connor F, Sweeney E, O’Morain C, Farrell RJ, Morrint M, Goggins M, McNulty JG, Weir DG, Kelleher D, Keeling PWN. Irish Society of Gastroenterology. Ir J Med Sci 1995. [PMCID: PMC7102063 DOI: 10.1007/bf02967835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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Arai T, Michalski JP, McCombs CC, Elston RC, McCarthy CF, Stevens FM. T cell receptor gamma gene polymorphisms and class II human lymphocyte antigen genotypes in patients with celiac disease from the west of Ireland. Am J Med Sci 1995; 309:171-8. [PMID: 7879822 DOI: 10.1097/00000441-199503000-00008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Although celiac disease has one of the strongest human lymphocyte antigen (HLA) class II associations of any human illness, it is clear that at least one gene that is not linked to the HLA region also is required for its pathogenesis. The occurrence of large numbers of gamma delta T cells in the bowel mucosa of patients and the recent description of T cell receptor (TCR) gamma chain polymorphic variants identified by restriction fragment length polymorphism analysis led the authors to examine TCR gamma genotypes in relation to HLA-DR, DQ genotypes in 89 patients with celiac disease and 55 control subjects from the West of Ireland. The overall frequency of TCR gamma genotypes in patients and control subjects was comparable. However, most of the patients had 1 of 3 HLA-DR3 genotypes (DR3/15, 3/7, or 3/3), and there was a significant alteration of the expected frequency of TCR gamma genotypes among patients with these three genotypes. The major differences were an increased association of HLA-DR3 homozygosity, with TCR gamma genotypes having a 16.0 kb fragment and an increased frequency of DR3/7 heterozygosity and decreased frequency of DR3/15 heterozygosity, respectively, in association with the TCR gamma 13.0/11.3 kb genotype. Based on their results, there is the possibility that an interaction between the products of two polymorphic and unlinked gene regions contributes to the pathogenesis of celiac disease.
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Affiliation(s)
- T Arai
- Department of Internal Medicine, University of South Alabama, Mobile 36688
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Carson KD, Grimes SB, McGinley JM, Thornton MT, Mulhall J, Bourke AM, McCrory C, Marsh B, Hone R, Phelan D, White M, Fabry J, Hughes D, Carson K, Donnelly M, Shanahan E, Fitzpatrick GJ, Bourke M, Warde D, Buggy D, Hughes N, Taylor A, Dowd N, Markham T, Blunnie W, Nicholson G, O’Leary E, Cunningham AJ, Dwyer R, McMechan S, Cullen C, Dempsey G, Wright G, MacKenzie G, Anderson J, Adgey J, Walsh M, O’Callaghan P, Graham I, O’Hare JA, Geoghegan M, Iman N, Shah P, Chander R, Lavin F, Daly K, Johnston PW, Imam Z, Adgey AAJ, Rusk RA, Richardson SG, Hale A, Kinsella BM, FitzGerald GA, King G, Crean P, Gearty G, Cawley T, Docherty JR, Geraghty J, Osborne H, Upton J, D’Arcy G, Stinson J, Cooke T, Colgan MP, Hall M, Tyrrell J, Gaffney K, Grouden M, Moore DJ, Shanik G, Feely J, Delanty N, Reilly M, Lawson JA, Fitzgerald DJ, Reilly MP, McAdam BF, Bergin C, Walshe MJ, Herity NA, Allen JD, Silke B, Singh HP, O’Neill S, Hargrove M, Coleman E, Shorten E, Aherne T, Kelly BE, Hill DH, McIlrath E, Morrow BC, Lavery GG, Blackwood B, Fee JPH, Kevin L, Doran M, Tansey D, Boylan I, McShane AJ, O’Reilly G, Tuohy B, Grainger P, Larkin T, Mahady J, Malone J, Condon C, Donoghue T, O’Leary J, Lyons JF, Tay YK, Tham SN, Khoo Tan HS, Gibson G, O’Grady A, Leader M, Walshe J, Carmody M, Donohoe J, Murphy GM, O’Connor W, Barnes L, Watson R, Darby C, O’Moore R, Mulcahy F, O’Toole E, O’Briain DS, Young MM, Buckley D, Healy E, Rogers S, Ni Scannlain N, McKenna MJ, McBrinn Y, Murray B, Freaney R, Barrett E, Razza Q, Abuaisha F, Powell D, Murray TM, Powell AM, O’Mongain E, O’Neill J, Kernan RP, O’Connor P, Clarke D, Fearon U, Cunningham SK, McKenna TJ, Hayes F, Heffernan A, Sheahan K, Harper R, Johnston GD, Atkinson AB, Sheridan B, Bell PM, Heaney AP, Loughrey G, McCance DR, Hadden DR, Kennedy AL, McNamara P, O’Shaughnessy C, Loughrey HC, Reid I, Teahan S, Caldwell M, Walsh TN, McSweeney J, Hennessy TP, Caldwell MTP, Byrne PJ, Hennessy TPJ, El-Magbri AA, Stevens FM, O’Sullivan R, McCarthy CF, Laundon J, Heneghan MA, Kearns M, Goulding J, Egan EL, McMahon BP, Hegarty F, Malone JF, Merriman R, MacMathuna P, Crowe J, Lennon J, White P, Clarke E, Prabhakar MC, Ryan E, Graham D, Yeoh PL, Kelly P, McKeogh D, O’Keane C, Kitching A, Mulligan E, Gorey TF, Mahmud N, O’Connell M, Goggins M, Keeling PWN, Weir DG, Kelleher D, McDonald GSA, Maguire D, O’Sullivan G, Harvey B, Cherukuri A, McGrath JP, Timon C, Lawlor P, O’Shea J, Buckley M, English L, Walsh T, O’Morain C, Lavelle SM, Kanagaratnam B, Harding B, Murphy B, Kavanagh J, Kerr D, Lavelle E, O’Gorman T, Liston S, Fitzpatrick C, Fitzpatrick P, Turner M, Murphy AW, Cafferty D, Dowling J, Bury G, Kaf Al-Ghazal S, Zimmermann E, O’Donoghue J, McCann J, Sheehan C, Boissel L, Lynch M, Cryan B, Fanning S, O’Meara D, Fennell J, Byrne PM, Lyons D, Mulcahy R, Pooransingh A, Walsh JB, Coakley D, O’Neill D, Ryall N, Connolly P, Namushi R, Lawler M, Locasciulli A, Bacigalupo A, Humphries P, McCann SR, Pamphilon D, Reidy M, Madden M, Finch T, Borton M, Barnes CA, Lawlor SE, Gardiner N, Egan LJ, Orren A, Doherty J, Curran C, O’Hanlon D, Kent P, Kerin M, Maher D, Given HF, Lynch S, McManus R, O’Farrelly C, Madrigal L, Feighery C, O’Donoghue D, Whelan CA, Rea IM, Stewart M, Campbell P, Alexander HD, Crockard AD, Morris TCM, Maguire H, Davidson F, Kaminski GZ, Butler K, Hillary IB, Parfrey NA, Crowley B, McCreary C, Keane C, O’Reilly M, Goh J, Kennedy M, Fitzgerald M, Scott T, Murphy S, Hildebrand J, Holliman R, Smith C, Kengasu K, Riain UN, Cormican M, Flynn J, Glennon M, Smith T, Whyte D, Keane CT, Barry T, Noone D, Maher M, Dawson M, Gilmartin JJ, Gannon F, Eljamel MS, Allcut D, Pidgeon CN, Phillips J, Rawluk D, Young S, Toland J, Deveney AM, Waddington JL, O’Brien DP, Hickey A, Maguire E, Phillips JP, Al-Ansari N, Cunney R, Smyth E, Sharif S, Eljamel M, Pidgeon C, Maguire EA, Burke ET, Staunton H, O’Riordan JI, Hutchinson M, Norton M, McGeeney B, O’Connor M, Redmond JMT, Feely S, Boyle G, McAuliffe F, Foley M, Kelehan P, Murphy J, Greene RA, Higgins J, Darling M, Byrne P, Kondaveeti U, Gordon AC, Hennelly B, Woods T, Harrison RF, Geary M, Sutherst JR, Turner MJ, DeLancey JOL, Donnelly VS, O’Connell PR, O’Herlihy C, Barry-Kinsella C, Sharma SC, Drury L, Lewis S, Stratton J, Ni Scanaill S, Stuart B, Hickey K, Coulter-Smith S, Moloney A, Robson MS, Murphy M, Keane D, Stronge J, Boylan P, Gonsalves R, Blankson S, McGuinness E, Sheppard B, Bonnar J, MacDonagh-White CM, Kelleher CC, Newell J, White O, Young Y, Hallahan C, Carroll K, Tipton K, McDermott EW, Reynolds JV, Nolan N, McCann A, Rafferty R, Sweeney P, Carney D, O’Higgins NJ, Duffy MJ, Grimes H, Gallagher S, O’Hanlon DM, Strattan J, Lenehan P, Robson M, Cusack YA, O’Riordain D, Mercer PM, Smyth PPA, Gallagher HJ, Moule B, Cooke TG, McArdle CS, Burke C, Vance A, Saidtéar C, Early A, Eustace P, Maguire L, Cullinane ABP, Prosser ES, Coca-Prados M, Harvey BJ, Saidléar C, Orwa S, Fitzsimons RB, Bradley O, Hogan M, Zimmerman L, Wang J, Kuliszewski M, Liu J, Post M, Premkumar, Conran MJ, Nolan G, Duff D, Oslizlok P, Denham B, O’Connell PA, Birthistle K, Hitchcock R, Carrington D, Calvert S, Holmes K, Smith DF, Hetherton AM, Mott MG, Oakhill A, Foreman N, Foot A, Dixon J, Walsh S, Mortimer G, O’Sullivan C, Kilgallen CM, Sweeney EC, Brayden DJ, Kelly JG, McCormack PME, Hayes C, Johnson Z, Dack P, Hosseini J, O’Connell T, Hemeryck L, Condren L, McCormack P, McAdam B, Lawson J, Keimowitz R, O’Leary A, Pilkington R, Adebayo GI, Gaffney P, McGettigan P, McManus J, O’Shea B, Wen Y, Killalea S, Golden J, Swanwick G, Clare AW, Mulvany F, Byrne M, O’Callaghan E, Byrne H, Cannon N, Kinsella T, Cassidy B, Shepard N, Horgan R, Larkin C, Cotter D, Coffey VP, Sham PC, Murray LH, Lane A, Kinsella A, Murphy P, Colgan K, Sloan D, Gilligan P, McEnri J, Ennis JT, Stack J, Corcoran E, Walsh D, Thornton L, Temperley I, Lawlor E, Tobin A, Hillary I, Nelson HG, Martin M, Ryan FM, Christie MA, Murray D, Keane E, Holmes E, Hollyer J, Strangeways J, Foster P, Stanwell-Smith R, Griffin E, Conlon T, Hayes E, Clarke T, Fogarty J, Moloney AC, Killeen P, Farrell S, Clancy L, Hynes M, Conlon C, Foley-Nolan C, Shelley E, Collins C, McNamara E, Hayes B, Creamer E, LaFoy M, Costigan P, Al fnAnsari N, Cunney RJ, Smyth EG, Johnson H, McQuoid G, Gilmer B, Browne G, Keogh JAB, Jefferson A, Smith M, Hennessy S, Burke CM, Sreenan S, Power CK, Pathmakanthan S, Poulter LW, Chan A, Sheehan M, Maguire M, O’Connor CM, FitzGerald MX, Southey A, Costello CM, McQuaid K, Urbach V, Thomas S, Horwitz ER, Mulherin D, FitzGerald O, Bresnihan B, Kirk G, Veale DJ, Belch JJF, Mofidi A, Mofidi R, Quigley C, McLaren M, Veale D, D’Arrigo C, Couto JC, Woof J, Greer M, Cree I, Belch J, Hone S, Fenton J, Hamilton S, McShane D. National Scientific Medical Meeting 1994 Abstracts. Ir J Med Sci 1994. [DOI: 10.1007/bf02943102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Brown bowel syndrome is the name applied to a brown discoloration of the intestine. This is due to lipofuscin deposition in intestinal smooth muscle and occurs in association with malabsorption. Three cases occurring in a coeliac registry of 559 patients are described. One patient presented with acute massive bleeding per rectum, and two were diagnosed at autopsy. The syndrome may be accompanied by vitamin E deficiency and neurologic dysfunction. Two patients had evidence of peripheral neuropathy, and one had low vitamin E levels. Concomitant vitamin D deficiency was present. Fat-soluble vitamin malabsorption, especially if there is a poor response to a gluten-free diet or neuropathy, might alert the clinician to the possibility of brown-bowel syndrome and suggests careful search for lipofuscin in biopsy material, using special histologic techniques.
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Affiliation(s)
- C E Connolly
- Dept. of Pathology, University College Hospital, Galway, Ireland
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Mealy K, Adeyoju A, O’Nullain E, Smyth H, Keane FBV, Reen D, Tanner A, Wang JH, Redmond HP, Watson RWG, Duggen S, Boucher-Hayes D, Casey M, Stevens FM, Bruzzi J, El-Magbri AA, Stevens FM, McCarthy CF, Egan LJ, Johnston J, Walsh S, Murphy RP, O’Gorman T, Headon DR, Connolly CE, Johnston S, Tham TCK, Watson RGP, O’Donnell LJD, Battistini B, Warner TD, Fournier A, Farthing MJG, Vane RJ, Skelly MM, Mulcahy HE, O’Donoghue DP, McDermott EWM, Al Khalifa K, Murphy JJ, Goggins M, Mahmud N, Keeling PWN, Weir DC, Kelleher D, Keogh IJ, Kerin MJ, O’Hanlon D, Kent P, Callaghan J, Given HF, Buckley M, Sweeney K, Xia HX, Keane CT, O’Morain C, Farrell RJ, Khan MI, Cherukuri AK, Moloney M, Weir DG, Harden CA, Boyle TJ, Condon F, Stephens RB, Berend KR, DiMaio JM, Coles RE, Lyerly HK, Abuzakouk M, Feighery C, Casey E, O’Farrelly C, Meagher P, Austin O, Phillips J, Cleary AP, Deasy J, McKeogh D, Merriman R, MacMathuna P, O’Keane C, Hone R, Lennon J, Crowe J, Kane D, McKiernan M, Mac Mathuna P, Clarke E, Kilgallen CK, Mooney EE, Stephens R, Sweeney E, Carroll T, Stokes MA, Regan MC, Waldon DJ, Jonsson T, Fitzpatrick JM, Gorey TF, Duggan M, Mulligan E, Bannon C, Morrin M, Khan F, Barrett N, Delaney P, Todd A, Madhaven P, O’Sullivan R, Durkan M, Nyhan T, Lynch G, Egan TJ, Delaney PV, O’Connell M, Neary P, Reid S, Horgan P, Shami J, Traynor O, Fan XG, Chua A, Fan XJ, O’ Byrne K, Khan I, Farrell R, Daly P, Cherukuril AK, Farrell RI, Maloney M, Noonan N, Carey C, Keane C, Syed Asad A, Lane B, Browne HI, Keeling P, Baldota S, Madden C, Johnston JG, Waldron R, Kenny-Walsh E, Welton MJ, Hyland J. Irish society for gastroenterology. Ir J Med Sci 1994. [DOI: 10.1007/bf02943012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Watson RWG, Redmond HP, McCarthy J, Burke P, Bouchier-Hayes D, Kelly C, Watson RGK, Duggan S, Ahmad M, Croke DT, El-Magbri AA, Stevens FM, McCarthy CF, O’Connor H, Kanduru C, Cunnane K, Marshall DG, Chua A, Keeling PWN, Sullivan DJ, Coleman D, Smyth CJ, Caldwell MTP, Marks P, Byrne PJ, Walsh TN, Hennessy TPJ, Reid IM, Hickey K, Deb B, O’Callaghan P, Lawlor P, Crean P, Grehan D, Sweeney EC, Kelly CJ, Rajpal P, Couse NF, Khan F, Delaney PV, Lynch S, Kelleher D, McManus R, O’Farrelly C, Pule MA, Lynch S, Madrigal L, Hegarty J, Traynor O, McEntee G, Sheahan K, Carey E, Stack WA, Mulcahy H, O’Donoghue DP, Goggins M, Mahmud N, Weir DG, Keely SJ, Baird AW, Farrell RJ, Khan MI, Cherukuri AK, Noonan N, Boyle TJ, Roddie ME, Williamson RCN, Habib NA, Sharifi Y, Courtney MG, Fielding JF, Abuzakouk M, Feighery C, Jones E, O’Briain S, Casey E, Prabhakar MC, MacMathuna P, Lennon J, Crowe J, Merriman R, Ryan E, Kitching A, Mulligan E, Kelly P, Gorey TF, Lennon JR, McGrath JP, Timon C, Gormally SM, Baker A, MacMahon P, Tangney N, Mowet A, Drumm B, Kierce B, Daly L, Bourke B, Carroll R, Durnin M, Prakash N, Clyne M, Cahill RJ, Kilgallen C, Beattie S, Hamilton H, O’Morain CA, Xia HX, English L, Keane CT, Fenton J, Hone S, Gormley P, O’Dwyer T, McShane D, Leonard N, Hourihane D, Whelan A, Maguire D, O’Sullivan GC, Harvey B, Farrell R, Maloney M, O’Byrne K, Carey C, Meagher PJ, Deasy JM, Barrett J, Collins JK, O’Sullivan GC. Irish society of gastroenterology. Ir J Med Sci 1993. [DOI: 10.1007/bf03022586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bourke M, O'Donovan M, Stevens FM, McCarthy CF. Alpha 1-antitrypsin phenotypes in coeliac patients and a control population in the west of Ireland. Ir J Med Sci 1993; 162:171-2. [PMID: 8335451 DOI: 10.1007/bf02945176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
alpha 1 antitrypsin or protease inhibitor (Pi) phenotyping was carried out on 111 coeliac disease patients (CD) and 250 controls. The Pi MM phenotype was present in 95 (85.6%) of the coeliacs and 225 (90%) of the controls. The groups did not differ significantly with regard to Pi phenotypes. In the CD group the Pi Phenotype did not relate to HLA B8 or DR3 status. Associated diseases in the CD patients did not correlate with Pi phenotype.
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Affiliation(s)
- M Bourke
- Department of Medicine, University College Hospital, Galway
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Mannion A, Stevens FM, McCarthy CF, Grimes-O'Cearbhaill H, Killeen AA. Extended major histocompatibility complex haplotypes in celiac patients in the west of Ireland. Am J Med Genet 1993; 45:373-7. [PMID: 8434627 DOI: 10.1002/ajmg.1320450319] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The highest reported prevalence of celiac disease (gluten-sensitive enteropathy) is found in the West of Ireland. Recent genetic data have suggested that major histocompatibility complex-linked loci may have a dominant genetic effect for disease susceptibility in this population compared with a recessive effect in other groups. To further understand the role of the MHC in celiac disease in the West of Ireland, we analyzed markers for 22 MHC haplotypes from celiac patients and compared them with 18 nontransmitted haplotypes found in the parents of celiac children, and with reported haplotypes from other populations. An extended MHC haplotype including [HLA-B8, DR3, DQw2, Bf*S, C4A*Q0, and C4B*1] accounted for 50% of celiac haplotypes but only 27% of nontransmitted parental haplotypes. Compared with other reported haplotypes in celiacs, patients from the West of Ireland show a higher prevalence of HLA-A1 as a component of this extended haplotype, suggesting that although the core haplotype is similar between Irish patients and others, the celiac population in the West of Ireland differs at other HLA loci. We did not observe any other common haplotypes among our patients unlike the situation in other populations. These differences may underlie the possible dominant effect of HLA-linked loci and the unusually high prevalence of celiac disease in the Irish population. We also found that the serum levels of complement components C3c, C4, and factor B were significantly lower among celiac patients than nonceliacs. The lower serum level of C4 appears to be related to the presence of deletions and null alleles at the C4A and C4B loci in celiacs.
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Affiliation(s)
- A Mannion
- Department of Immunology, University College Hospital, Galway, Ireland
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Brannigan A, Williams NN, Grahn M, Williams NS, Fitzpatrick JM, O’Connell PR, Soong CV, Blair P, Halliday MI, Hood JM, Rowlands BJ, D’sa AABB, Cahill RJ, Beattie S, Hamilton H, O’Morain C, Kelly SJ, O’Malley KE, Stack WA, O’Donoghue D, Baird AW, Cronin KJ, Kerin MJ, Crowe J, MacMathuna P, Lennon J, Gorey TF, Chua A, O’Kane V, Dinan TG, Keeling PWN, Mulligan E, Cronin KL, Dervan P, Ireland A, Murphy D, O’Sullivan G, Ryan E, Kelly P, Gilvarry J, Sant S, Fan XJ, Chua A, Shahi CN, O’Connell M, Weir DG, Kelleher D, McDevitt J, O’Donoghue JM, Horgan PG, Byrne WJ, McGuire M, Given HF, Daw MA, Kavanagh P, O’Mahony P, Joy T, Gleeson F, Mullan A, Gibney M, Mannion A, Stevens FM, McCarthy CF, Killeen AA, Murchan PM, Reynolds JV, Leonard N, Marks P, Keane FBV, Tanner WA, O’Connell MA, Corridan B, Collins R, Shannon R, Cahill R, Joyce WP, Goggin M, O’Donoghue D, Hyland J, Traynor O, Qureshi A, DaCosta M, Brindley N, Burke P, Grace P, Bouchier-Hayes D, Leahy AL, Courtney G, Osbome H, O’Donovan N, O’Donoghue M, Collins JK, Morrissey D, McCarthy JE, Redmond HP, Hill ADK, Grace PA, Naama H, Austin OM, Bouchier-Hayes DM, Daly JM, Mulligan E, Fitzpatrick JM, Breslin D, Delaney CP, O’Sullivan ST, O’Sullivan GC, Kirwan WO, Weir CD, McGrath LT, Maynard S, Anderson NH, Halliday MI, D’sa AABB, Gokulan C, O’Gorman TA, Breshihan E, Lam PY, Skehill R, Grimes H, McKeever JA, Stokes MA, Mehigan D, Keaveny TV, Meehan J, Molloy A, Q’Farrelly C, Scott J, Dudeney MS, Leahy A, Grace. PA, McEntee G, Hcaton ND, Douglas V, Mondragon R, O’Grady J, Williams R, Tan KC, Xia HX, Keane CT, O’Morain CA, O’Mahony A, O’Sullivan GC, Corbett A, O’Mahony A, Ireland A, Harte P, Mulcahy H, Patchett S, Stack W, Gallagher M, Connolly K, Doyle J, Flynn JR, Maher M, Hehir D, Horgan A, Stuart R, Brady MP, Johnston PW, Johnston BT, Collins BJ, Collins JSA, Love AHG, Marshall SG, Parks TG, Spence RAJ, O’Connor HJ, Cunnane K, Duggan M, MacMalhuna P, Delaney CP, Kerin M, Gorey TF, Attwood SEA, Viani L, Jeffers M, Walsh TN, Byrne PJ, Frazer I, Hennessy TPJ, Hill GL, Dickey W, McMillan SA, Bharucha C, Porter KG, Rolfe H, Thornton J, Attwood SEA, Coleman J, Stephens RB, Hone S, Holmes K, Kelly IP, Corrigan TP, McCrory D, McCaigue M, Barclay GR, Stack WA, Quirke M, Hegarty JE, O’Donoghue DP, O’Hanlon D, Byrne J. Irish society of gastroenterology. Ir J Med Sci 1992. [DOI: 10.1007/bf02942367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Savage DA, Middleton D, Trainor F, Taylor A, Carson M, Stevens FM, McCarthy CF. HLA class II frequencies in celiac disease patients in the West of Ireland. Hum Immunol 1992; 34:47-52. [PMID: 1356956 DOI: 10.1016/0198-8859(92)90084-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Restriction fragment length polymorphism analysis, using a single restriction enzyme TaqI-multiple-probe system for HLA-DRB1-DQB1 and -DQA1, was used to determine HLA-DR and -DQ frequencies in 56 unrelated celiac patients and 47 unrelated controls from the west of Ireland. In addition, HLA-DPB1 allelic frequencies were determined in the same group of patients and controls by using the technique of enzymatic DNA amplification of the polymorphic second exon of HLA-DPB1 genes in conjunction with sequence-specific oligonucleotide probing. The results suggest that HLA-DQ rather than HLA-DR is more important in conferring susceptibility to celiac disease. Furthermore, no association between HLA-DP and celiac disease was found in this study.
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Affiliation(s)
- D A Savage
- Northern Ireland Tissue Typing Service, Belfast City Hospital
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Affiliation(s)
- J Cahill
- Department of Medicine, University College Hospital, Galway
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Hannigan M, Bourke M, Stevens FM, McCarthy CF. Gm typing of Irish coeliac patients and controls does not help locate the "second" coeliac gene. Ir J Med Sci 1991; 160:57-8. [PMID: 1917425 DOI: 10.1007/bf02947649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A two gene model has been proposed to explain the inheritance of coeliac disease (CD). One gene is on chromosome 6 in the MHC complex (HLA associated). It has been suggested the second gene is located on chromosome 14, in or near the region encoding for immunoglobulin heavy chain allotypes (Gm types). In a study of 102 unrelated Irish coeliacs and a group of ethnic controls, we have failed to show an association of CD with any particular Gm type or types. There is no evidence to confirm that a gene on chromosome 14 is implicated in the inheritance of CD.
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Affiliation(s)
- M Hannigan
- University Department of Medicine, University College Hospital, Galway, Ireland
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Hernández JL, Michalski JP, McCombs CC, McCarthy CF, Stevens FM, Elston RC. Evidence for a dominant gene mechanism underlying coeliac disease in the west of Ireland. Genet Epidemiol 1991; 8:13-27. [PMID: 2060769 DOI: 10.1002/gepi.1370080103] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Although coeliac disease (CD) is strongly associated with the HLA alleles B8 and DR3, the genetic basis of this illness remains obscure. Recent studies show that at least two unlinked loci are involved. Most studies agree on recessivity at the HLA-unlinked locus but differ with respect to dominance or recessivity at the HLA-linked disease susceptibility locus. To address this controversy, we examined the association of CD with HLA in 39 families from the West of Ireland. Previous studies have shown that the prevalence of CD and the frequencies of the HLA antigens associated with it are higher in this population than in most others. Analysis of the data revealed a significant excess of concordant sib-pairs with two HLA haplotypes in common and an excess of discordant pairs with no haplotype in common. Chi-square tests confirmed a highly significant association between HLA-B8 and CD. Both heterozygotes and homozygotes for B8 had a significantly increased risk of CD. The risk for homozygotes was slightly higher than for heterozygotes, although not significantly so. The segregation ratio for disease occurrence among sibs of probands was estimated to be 0.185 when neither parent is affected. We estimated a gene frequency of 0.003 for the disease allele (C) at the HLA-linked locus and of 0.648 for the disease allele (d) at the HLA-unlinked locus. Assuming that CCdd homozygotes are always affected and that only carriers of C who are homozygous dd can be affected, the disease was found to be completely penetrant in Ccdd heterozygotes. These results support dominance at the HLA-linked locus conferring susceptibility to CD. Possible reasons for the discrepancy between the West of Ireland and other populations are discussed.
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Affiliation(s)
- J L Hernández
- Department of Biometry and Genetics, Louisiana State University Medical Center, New Orleans 70112-1393
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Abstract
The clinical, radiological and pathological features of 7 patients with coeliac disease (CD) who developed lung abscesses or cavities are described. These patients were seen during a 20-year period during which time approximately 600 coeliacs were seen and 50 died. Six of the coeliac patients with lung abscess died. The patients were middle aged. Staphylococcal infection, Klebsiella pneumoniae, bronchial carcinoma and previous pulmonary tuberculosis accounted for the cavities in 4 patients. In the 3 other patients a definite cause could not be identified. Hyposplenism and malnutrition were common. Next to malignancy pulmonary abscess was the commonest cause of death in the coeliac population. The development of respiratory symptoms should be regarded as a potentially serious and a life-threatening event in the middle-aged coeliac patients. Lung abscess should be added to the list of respiratory diseases associated with coeliac disease.
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Affiliation(s)
- F M Stevens
- University Department of Medicine, University College Hospital, Galway, Ireland
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Colaco J, Egan-Mitchell B, Stevens FM, Fottrell PF, McCarthy CF, McNicholl B. The teenage coeliac. Arch Dis Child 1989; 64:1093-4. [PMID: 2629637 PMCID: PMC1792687 DOI: 10.1136/adc.64.7.1093-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Abstract
A 40 year old man with two month history of vomiting and weight loss, was found to have multiple strictures in his small bowel. Investigations outruled known causes of small bowel ulceration, and the flat bowel mucosa did not respond to a gluten free diet. Treatment with steroids conferred a temporary benefit, however, small bowel ulceration persisted.
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Abstract
Fifty two children in whom coeliac disease was confirmed by persistent enteropathy while they were taking gluten were monitored to assess the effects of compliance with a gluten free diet (GFD). Between the ages of 17.8 and 18.5 years height (in 45 patients followed up for a mean of 14.9 years) and weight (in 43 followed up for a mean of 15.2 years) were significantly lower in those complying poorly with a GFD compared with those complying well. Of the 37 patients still attending the clinic after a mean of 25 years, having been followed up for a mean of 18.4 years, 16 who had complied well with the diet had normal or only slightly abnormal mucosal morphology whereas all 10 who had not complied had abnormal morphology. In these 10 lactase, sucrase, and alkaline phosphatase activities were significantly less than values in those who complied well. Mucosal sucrase and alkaline phosphatase activities in those who complied well were no different from those in a control population, whereas lactase activity was significantly lower. It is concluded that failure to comply with a GFD during childhood results in decreased adult stature and in persisting active enteropathy with depressed brush border enzyme activity.
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Abstract
Between 1960 and 1974 the incidence of coeliac disease in children under 12 years in County Galway remained fairly constant, but since 1975 it has fallen by 62% and the lowered incidence seems well established. The number of those who were breast fed and the age at which first gluten feeding took place during the 22 years both increased significantly and from the mid-70s total protein content and osmolarity of proprietary cow's milk formulas were reduced. All three factors may be relevant. A negative correlation with the incidence of gastroenteritis was found.
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Abstract
An increased association of ulcerative colitis and coeliac disease has been reported, as have the results of several small-bowel biopsy studies in ulcerative colitis. Forty-two patients from a population of 438 patients with coeliac disease had rectal biopsies. Fourteen of these showed inflammation of various degrees of severity, including three compatible with a diagnosis of ulcerative colitis. The presenting complaint in 34 of these patients was diarrhoea or steatorrhoea. Twenty-seven patients had coeliac disease diagnosed at the same time or after their rectal biopsy. The other 15 were previously diagnosed coeliacs. Twelve of the 14 patients with abnormal rectal biopsy specimens were known to have subtotal/total villous atrophy at the time of rectal biopsy. Proctitis as seen in these coeliac patients had no unique features to differentiate it from proctitis caused by other disorders. The diarrhoea/steatorrhoea stopped in all patients on commencement of a gluten-free diet, except in those with ulcerative colitis. Proctitis is common in patients with coeliac disease presenting with diarrhoea/steatorrhoea. This study supports the finding of an increased association of coeliac disease and ulcerative colitis and is, to our knowledge, the first rectal biopsy study of a coeliac population.
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Moorehead RJ, Donaldson J, McKelvey STD, Drumm J, Harding LK, Clarke EA, Alexander-Williams J, Donovan IA, Lorigan G, Butler F, Broe PJ, O’Hara MJ, McCormick PA, Molloy A, McGrath D, O’Donoghue DP, Farrell T, O’Donoghue D, Daly L, Masterson JB, Breen EG, Coughlan J, Connolly CE, Stevens FM, McCarthy CF, Tobin MV, Fiskan RA, Dissory RT, Gilmore IT, McCormick D, Cullen A, McCormick PA, Towers RP, Keane RM, Coleman JE, Clery AP, Keane T, Dillon B, Afdhal NH, McCormick CJ, Stevens FM, Connolly CE, McCarthy CF, Hitchcock H, Waldron DJ, Fitzgerald RJ, Quigley EMM, Hall L, Turnberg LA, Brennan FN, Buchanan KD, Afdhal NH, Duffy MJ, Thornton A, O’Sullivan F, O’Donoghue DP, Mullen P, O’Connor B, Lombard M, Coakley JB, Crowe J, Lennon JR, Keeling P, Hennessy TPJ, Gleeson D, Quereshi Y, Murphy GM, Dowling RH, O’Connor HJ, Dixon MF, Wyatt JI, Axon ATR, Gillen P, Keeling P, Byrne PJ, West AB, Hennessy TPJ, Walsh TN, O’Higgins N, Quigley EMM, Turnberg LA, O’Hara MJ, McCormick PA, McGowan K, Miller JC, Masterson J, O’Donoghue DP, Courtney MG, McPartlin JM, Scott JM, Weir DG, Wilson BG, Howe JP, Parks TG, McCormick PA, Ramsay N, Afdhal N, Tubridy P, Shattock AG, Hillery I, O’Donoghue DP, Collins JSA, Knill-Jones RP, Crean GP, Love AHG, Quigley EMM, Hole DJ, Gillis CR, Watkinson G, Moore H, Moylan HE, Fottrell PF, Stevens FM, Brady HR, Godson C, Ryan MP, Bourke S, FitzGerald MX, McCormick PA, O’Farrelly C, Graeme-Cook F, Finch A, Feighery C, Weir DG, O’Donoghue DP, FitzGerald MX, Maxwell WJ, Walsh JP, Hogan FP, Kennedy NP, Keeling PWN, Sheil O, Barniville H, Fitzgerald O. Irish Society of Gastroenterology Proceedings of the Summer Meeting of the Irish Society of Gastroenterology, held in Universitly College, Cork on Friday 6th and Saturday 7th June, 1986. Ir J Med Sci 1987. [DOI: 10.1007/bf02953236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
This paper examines the issue of non-attendance at outpatient clinics at the Regional Hospital, Galway, from the viewpoint of the patients who include both urban and rural residents. The results of a questionnaire survey of outpatients attending general and specialist medical and surgical clinics illustrate that very substantial costs are incurred and long periods of time are spent travelling by many patients. Females, and married females in particular, experience special difficulty in keeping appointments. Non-attendance increases as the cost of transport increases but many patients seriously underestimate the real cost of travel. Patients who have been attending over long periods of time have the worst record of non-attendance. It is recommended that any reorganisation of hospital outpatient systems in rural areas such as Western Ireland should take account of the particular needs of widely dispersed populations.
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Affiliation(s)
- M E Cawley
- Department of Geography, University College, Galway, Ireland
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Abstract
Non-steroidal anti-inflammatory agents (NSAIDS) are a well recognised cause of hepatotoxicity. Diclofenac, a relatively new NSAID, was first introduced into the UK in 1979. Five cases of hepatitis have recently been reported, principally in the French literature. We report the first fulminant case of hepatitis in the English literature in a patient taking diclofenac and indomethacin.
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O’Byrne P, Collins P, Johnson A, Ledwith M, Lane B, Bouchier-Hayes D, MacMathuna P, O’Reilly T, Barry M, Duanes-Laita A, Feely J, Keeling PWN, Cotter P, Burke G, Waldron R, Zinner MJ, Jaffe BM, Givan F, Keye G, Byrne P, O’Brien M, O’Farrelly C, Stevens F, McCarthy C, Feighery C, Weir DG, Hannigan MC, Stevens FM, McCarthy CF, Fottrell PF, O’Connor MP, Kennedy NP, Courtney MG, Kelleher D, Weir DW, Senapati A, Kitler ME, Thompson RPH, O’Shea B, Madigan D, Keeling P, Hennessy TPJ, Meenan JJ, Gaffney EF, Duigan JP, Johnson AH, Collins PB, Healy MV, Skehill R, Grimes H, O’Farrelly C, Kelly J, Rees R, Hoey H, Humphreys H, Dooley C, O’Leary D, Bourke S, McKenna D, Power B, Keane C, Sweeney E, O’Morain CA, Afdhal NH, McCormick A, O’Donoghue DP, Quigley EMM, Turnberg LA, Moorehead RJ, Hoper M, McKelvey STD, Tobbia I, Rafferty R, Gillen P, Stuart R, Dawson K, Collins JSA, McKnigh JA, Pyper PC, Love AHG, Dillon ME, O’Connor E, Keeling PWN, Broe PJ, Harte PI, Keane T, Garstin WIH, Buchanan KD, Walsh JP, Bloomfield FJ, Maxwell WJ, Hogan FP, O’Malley VP, Postier RG, Lombard M, Craven C, Spencer S, Crowe J, Quinn F, Templeton JL, Tobin MV, Hughes S, Gilmore IT, Keane RM, Johnson AB, Duenas-Laita A, Younger K, O’Brien T, Cotter J, Cullinane T, Whelton MJ, Waldron D, Bowes K, Given HF, Gawley WF, Gorey TF, Osborne DH, Lane BE, Collins PG, Boston VE, O’Mahony C. Irish society of gastroenterology. Ir J Med Sci 1986. [DOI: 10.1007/bf02962975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cryan EM, Stevens FM, Skehill R, Bourke M, Grimes H, McCarthy CF. Immunoglobulins in healthy controls: HLA-B8 and sex differences. Tissue Antigens 1985; 26:254-8. [PMID: 3878013 DOI: 10.1111/j.1399-0039.1985.tb00968.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Serum immunoglobulins were measured in one hundred and eighty-four healthy controls. One hundred and fifty-nine of these were also HLA typed. IgG levels did not differ with sex or HLA-B8 status. IgM levels did not differ with HLA-B8 status but were significantly higher in females than males. IgA levels were lower in females than males; they were also lower in HLA-B8 positive compared with HLA-B8 negative individuals; the lowest IgA levels were found in HLA-B8 positive females. The IgA variation may be relevant to the higher incidence of certain disorders among HLA-B8 positive individuals and among females.
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Abstract
Splenic function was assessed using 'pitted' erythrocyte counts in 61 first degree relatives of patients with coeliac disease. 'Pitted' erythrocyte counts were normal in 12 parents, but were raised in 20% of 49 siblings and/or children of coeliac patients. First degree relatives had higher 'pitted' erythrocyte counts than normal controls (p = 0.002). The counts were lower in coeliac relatives than in age matched coeliacs (p = 0.0001), but no difference was present between the relatives and coeliac patients whose small bowel mucosa was morphologically normal. Considerable interfamily variation was found in 'pitted' erythrocyte counts, both in the coeliac patients and first degree relatives, and the pattern tended to 'run true' within families. The genetic factor influencing splenic function in coeliac disease is not HLA-linked but seems to be associated with a second, probably recessive, gene influencing the inheritance of coeliac disease.
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Hannigan MC, Kennedy SM, Stevens FM, McCarthy CF, Little MPG, Murphy PD, Gill RC, Bowes KL, Malone DE, McCormick PA, Long A, Jones B, Bresnihan B, Moloney J, O’Donoghue DP, Dinsmore WW, McMaster D, Callerder ME, Love AHG, McGowan PF, O’Mahony C, O’Farrelly C, Mansfield M, Whelan CA, Weir DG, Feighery CF, Spence RAJ, Collins BJ, Parks TG, Crowe J, Minogue S, Lowe H, Jackson PT, Glasgow JFT, Carré IJ, Conway W, Rich AJ, Johnston IDA, Keye GD, Byrne PJ, Sheppard BL, West AB, Hennessy TPJ, Fielding JF, Dolan C, Kelly J, Monagan H, Feighery C, Brennan FN, Majury C, O’Connor FA, Murray F, Lennon JR, Unit GG, Collins JSA, Trouton TG, McFarland RJ, O’Callaghan TW, Morgan MA, Duignan J, Collins P, Johnson A, Dickson B, Ledwith M, Bouchier-Hayes D, Bloomfield FJ, Maxwell WJ, Walsh JP, Hogan FP, Kelleher D, Clayton Love W, Keeling PWN, Attwood SEA, Mealy K, Cafferkey M, Buckley T, Keane FB, Cooper GG, Gordon SA, Murray WR, Quigley EMM, Phillips SF, O’Brien CJ, Vento S, Eddleston ALWF, Williams R, Templeton JL, McKelvey STD, Humphreys WG, Brown JS, Monson JRT, Jones NAG, Vowden P, Brennan TG, Prakash D, Pearson FG, Hegarty J, Lombard M, Fitzgerald R, O’Callagan TW, Kernohan RM, Gilmartin D, McNulty J, Behan J, Osborne DH, Gillan P, Ryan W, Leahy A, Devlin HB, Peel ALG, Buchanan KD, O’Hare MMT, Sloan JM, Kennedy TL, Mahapatra DN, McKenna RM, Kearns M, Morrison P, Kelly KA. Irish Society of Gastroenterology. Ir J Med Sci 1985. [PMID: 4055322 DOI: 10.1007/bf02937184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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O'Grady JG, Harding B, Stevens FM, Egan EL, McCarthy CF. Influence of splenectomy and the functional hyposplenism of coeliac disease on platelet count and volume. Scand J Haematol 1985; 34:425-8. [PMID: 4012222 DOI: 10.1111/j.1600-0609.1985.tb00772.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Platelet count and volume were measured in 84 splenectomised subjects, 142 patients with coeliac disease and 77 healthy subjects. An inverse, non-linear correlation between platelet count and volume was found in healthy subjects and coeliac patients, but was not present in splenectomised subjects who had higher platelet counts (P = 0.0001) and mean platelet volumes (P = 0.0001) than healthy subjects. Platelet counts correlated with splenic function in patients with coeliac disease and were higher in patients with severe hyposplenism than in normosplenic coeliacs (P = 0.0001). Splenic function did not influence the mean platelet volume (MPV) in coeliac disease but normosplenic coeliacs had higher MPV than normal subjects (P = 0.05). Serum iron and red cell folate were not correlated to MPV in coeliac disease. We conclude that splenic function effects platelet count and volume in non-coeliac subjects and platelet count in coeliac disease. However, other unidentified factor(s) influence the MPV in coeliac disease.
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O'Grady JG, Stevens FM, McCarthy CF. Celiac disease: does hyposplenism predispose to the development of malignant disease? Am J Gastroenterol 1985; 80:27-9. [PMID: 3966450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Splenic size and function was assessed in eight patients with celiac disease and coexisting malignancy (six had small bowel lymphoma and two gastric adenocarcinoma). The size of the spleen was reduced in four of seven patients as seen at autopsy or radionucleotide scanning. Splenic function was studied using "pitted" erythrocyte counts, platelet counts, and Howell-Jolly bodies and was impaired in five of eight patients. Malignant disease developed in some celiacs with normal splenic size and function. Splenic function as measured by pitted erythrocyte counts was similar in the celiac patients with malignancy and appropriately matched nonmalignant celiacs. We conclude that hyposplenism in celiac disease does not influence the development of malignant disease.
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O'Grady JG, Stevens FM, Harding B, O'Gorman TA, McNicholl B, McCarthy CF. Hyposplenism and gluten-sensitive enteropathy. Natural history, incidence, and relationship to diet and small bowel morphology. Gastroenterology 1984; 87:1326-31. [PMID: 6489698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Splenic function was quantitatively assessed using "pitted" erythrocyte counts in 177 patients with gluten-sensitive enteropathy. Hyposplenism was found to be a common, but not inevitable, complication of gluten-sensitive enteropathy that fluctuated with disease activity. Splenic function improved after withdrawal of gluten from the diet and a close relationship was demonstrated between hyposplenism and the morphology of the small intestine. The severity of the hyposplenism increased with advancing age and prolongation of exposure to dietary gluten. Splenic function did not vary with the HLA-A, -B, and -DR antigens, but, due to the presence of HLA-B8 and -DR3 in the vast majority of patients, a role for this haplotype in the causation of the hyposplenism cannot be excluded.
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Stevens FM, Bourke MA, McCarthy CF. 51Cr-EDTA test for coeliac disease. Lancet 1984; 2:1156. [PMID: 6150212 DOI: 10.1016/s0140-6736(84)91589-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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