Advertisement

Letter: Celiac Disease Presenting After a Single Anastomosis Duodeno-Ileal Bypass and Sleeve Gastrectomy

  • Amelie Therrien
  • Marie-Pierre Renaud
  • Lilia-Maria Sanchez
  • Louise D’Aoust
  • Michel Lemoyne
Letter to the Editor
  • 13 Downloads

Dear Editor,

With great interest, we read the article written by Freeman and colleagues about the implications of celiac disease (CeD) among patients undergoing a gastric bypass [1]. The authors concluded that Roux-en-Y gastric bypass (RYGB) is safe for individuals with CeD. They reported on 68 patients who had abnormal serology or pathology prior to the operation, with only three individuals being diagnosed with CeD. However, acknowledging that CeD, and even celiac crisis, may be triggered following a surgery [2, 3]; it is important to know if among the 65 remaining patients with some abnormalities, new CeD cases were diagnosed after the bariatric surgery. We would also like to highlight “case 1,” a 42-year-old lady, non-adherent to the gluten-free diet (GFD), who lost 100% of excess weight in the first year after surgery. These questions were raised by a recent case of CeD at our institution, presenting with excessive weight loss 4 months after a single anastomosis duodeno-ileal...

Notes

Acknowledgements

The authors would like to thank Monika Shpokayte for proofreading the manuscript.

Authors’ Contributions

AT and ML wrote the letter. MPR and LD edited the letter. LMS interpreted the pathology slides. AT is the guarantor of the letter. All authors have approved the final letter.

Compliance with Ethical Standards

Conflict of Interest

The authors disclose no conflict of interest in relation to this work. Dr. Louise D’Aoust is on an advisory board for Shire for the use of teduglutide in short bowel syndrome. This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors. Dr. Amelie Therrien was supported by phase 1 award from Fonds de Recherche Santé Québec (FRQS) Programme FRQS/MSSS de formation pour médecins résidents en médecine spécialisée visant une carrière en recherche.

Informed Consent

The patient written informed consent was obtained for the publication of this letter.

References

  1. 1.
    Freeman LM, Strong AT, Sharma G, et al. Implications of celiac disease among patients undergoing gastric bypass. Obes Surg. 2018;28(6):1546–52.  https://doi.org/10.1007/s11695-017-3046-2.CrossRefGoogle Scholar
  2. 2.
    Jamma S, Rubio-Tapia A, Kelly CP, et al. Celiac crisis is a rare but serious complication of celiac disease in adults. Clin Gastroenterol Hepatol. 2010;8(7):587–90.  https://doi.org/10.1016/j.cgh.2010.04.009.CrossRefGoogle Scholar
  3. 3.
    Maple JT, Pearson RK, Murray JA, et al. Silent celiac disease activated by pancreaticoduodenectomy. Dig Dis Sci. 2007;52(9):2140–4.  https://doi.org/10.1007/s10620-006-9598-y.CrossRefGoogle Scholar
  4. 4.
    Cuenca-Abente F, Nachman F, Bai JC. Diagnosis of celiac disease during pre-operative work-up for bariatric surgery. Acta Gastroenterol Latinoam. 2012;42(4):321–4.Google Scholar
  5. 5.
    Pane A, Orois A, Careaga M, et al. Clinical onset of celiac disease after duodenal switch: a case report. Eur J Clin Nutr. 2016;70(9):1078–9.  https://doi.org/10.1038/ejcn.2016.65.CrossRefGoogle Scholar
  6. 6.
    Marini JM, Coghlan E, Laferrere L, et al. Severe malnutrition and celiac disease following gastric bypass surgery. Int J Case Reports Med. 2014;2014:1–5.  https://doi.org/10.5171/2014.130992.CrossRefGoogle Scholar
  7. 7.
    Ukkola A, Maki M, Kurppa K, et al. Changes in body mass index on a gluten-free diet in coeliac disease: a nationwide study. Eur J Intern Med. 2012;23(4):384–8.  https://doi.org/10.1016/j.ejim.2011.12.012.CrossRefGoogle Scholar
  8. 8.
    de Angelis N, Carra MC, Vincenzi F. Gluten-free diet in obese patients with celiac disease: an enemy of the bariatric surgeon? Obes Surg. 2012;22(6):995–6.  https://doi.org/10.1007/s11695-012-0626-z.CrossRefGoogle Scholar
  9. 9.
    Shoar S, Poliakin L, Rubenstein R, et al. Single anastomosis duodeno-ileal switch (SADIS): a systematic review of efficacy and safety. Obes Surg. 2018;28(1):104–13.  https://doi.org/10.1007/s11695-017-2838-8.CrossRefGoogle Scholar
  10. 10.
    Puzziferri N, Roshek 3rd TB, Mayo HG, et al. Long-term follow-up after bariatric surgery: a systematic review. JAMA. 2014;312(9):934–42.  https://doi.org/10.1001/jama.2014.10706.CrossRefGoogle Scholar
  11. 11.
    Costantino G, della Torre A, Lo Presti MA, et al. Treatment of life-threatening type I refractory coeliac disease with long-term infliximab. Dig Liver Dis. 2008;40(1):74–7.  https://doi.org/10.1016/j.dld.2006.10.017.CrossRefGoogle Scholar
  12. 12.
    Murray JA, Rubio-Tapia A, Van Dyke CT, et al. Mucosal atrophy in celiac disease: extent of involvement, correlation with clinical presentation, and response to treatment. Clin Gastroenterol Hepatol. 2008;6(2):186–93; quiz 25.  https://doi.org/10.1016/j.cgh.2007.10.012.CrossRefGoogle Scholar
  13. 13.
    Hoerter NA, Shannahan SE, Suarez J, et al. Diagnostic yield of isolated deamidated gliadin peptide antibody elevation for celiac disease. Dig Dis Sci. 2017;62(5):1272–6.  https://doi.org/10.1007/s10620-017-4474-5.CrossRefGoogle Scholar
  14. 14.
    de Chaisemartin L, Meatchi T, Malamut G, et al. Application of deamidated gliadin antibodies in the follow-up of treated celiac disease. PLoS One. 2015;10(8):e0136745.  https://doi.org/10.1371/journal.pone.0136745.CrossRefGoogle Scholar
  15. 15.
    Lau MS, Mooney PD, White WL, et al. The role of an IgA/IgG-deamidated gliadin peptide point-of-care test in predicting persistent villous atrophy in patients with celiac disease on a gluten-free diet. Am J Gastroenterol. 2017;112(12):1859–67.  https://doi.org/10.1038/ajg.2017.357.CrossRefGoogle Scholar
  16. 16.
    Tosco A, Maglio M, Paparo F, et al. Immunoglobulin A anti-tissue transglutaminase antibody deposits in the small intestinal mucosa of children with no villous atrophy. J Pediatr Gastroenterol Nutr. 2008;47(3):293–8.  https://doi.org/10.1097/MPG.0b013e3181677067.CrossRefGoogle Scholar
  17. 17.
    Gatti S, Rossi M, Alfonsi S, et al. Beyond the intestinal celiac mucosa: diagnostic role of anti-TG2 deposits, a systematic review. Front Med (Lausanne). 2014;1:9.  https://doi.org/10.3389/fmed.2014.00009.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Medicine, Division of GastroenterologyCentre Hospitalier de l’Université de MontrealMontrealCanada
  2. 2.Beth Israel Deaconess Medical CenterBostonUSA
  3. 3.Hôpital Anna-LabergeChâteauguayCanada
  4. 4.Department of PathologyCentre Hospitalier de l’Université de MontréalMontrealCanada

Personalised recommendations