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Gastroenterology Research and Practice
Volume 2012 (2012), Article ID 637187, 9 pages
http://dx.doi.org/10.1155/2012/637187
Review Article

Atypical Celiac Disease: From Recognizing to Managing

1Laboratory of Immunology, Faculty of Medicine and University Hospital Center, BP 7010, Sidi Abbad, Marrakech, Morocco
2Laboratory of Research “PCIM”, Faculty of Medicine, University Cadi Ayyad, Marrakech, Morocco
3Service of Internal Medicine, University Hospital Center, Marrakech, Morocco
4Service of Gastroenterology, University Hospital Center, Marrakech, Morocco
5Service of Peadiatrics, University Hospital Center, Marrakech, Morocco
6Laboratory of Biochemistry, University Hospital Center, Marrakech, Morocco
7Laboratory of Histopathology, University Hospital Center, Marrakech, Morocco

Received 8 January 2012; Accepted 8 May 2012

Academic Editor: Govind K. Makharia

Copyright © 2012 B. Admou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. L. M. Sollid, S. N. McAdam, O. Molberg et al., “Genes and environment in celiac disease,” Acta Odontologica Scandinavica, vol. 59, no. 3, pp. 183–186, 2001. View at Publisher · View at Google Scholar · View at Scopus
  2. M. Mäki, K. Mustalahti, J. Kokkonen et al., “Prevalence of celiac disease among children in Finland,” New England Journal of Medicine, vol. 348, no. 25, pp. 2517–2524, 2003. View at Publisher · View at Google Scholar · View at Scopus
  3. G. Telega, T. R. Bennet, and S. Werlin, “Emerging new clinical patterns in the presentation of celiac disease,” Archives of Pediatrics and Adolescent Medicine, vol. 162, no. 2, pp. 164–168, 2008. View at Publisher · View at Google Scholar · View at Scopus
  4. E. J. Hoffenberg, T. MacKenzie, K. J. Barriga et al., “A prospective study of the incidence of childhood celiac disease,” Journal of Pediatrics, vol. 143, no. 3, pp. 308–314, 2003. View at Publisher · View at Google Scholar · View at Scopus
  5. M. Abu-Zekry, D. Kryszak, M. Diab, C. Catassi, and A. Fasano, “Prevalence of celiac disease in egyptian children disputes the east west agriculture-dependent spread of the disease,” Journal of Pediatric Gastroenterology and Nutrition, vol. 47, no. 2, pp. 136–140, 2008. View at Publisher · View at Google Scholar · View at Scopus
  6. K. Alarida, J. Harown, A. Ahmaida et al., “Coeliac disease in Libyan children: a screening study based on the rapid determination of anti-transglutaminase antibodies,” Digestive and Liver Disease, vol. 43, no. 9, pp. 688–691, 2011. View at Publisher · View at Google Scholar · View at Scopus
  7. M. B. Hariz, M. Kallel-Sellami, L. Kallel et al., “Prevalence of celiac disease in Tunisia: mass-screening study in school children,” European Journal of Gastroenterology and Hepatology, vol. 19, no. 8, pp. 687–694, 2007. View at Publisher · View at Google Scholar · View at Scopus
  8. F. Imanzadeh, A. A. Sayyari, M. Yaghoobi, M. R. Akbari, H. Shafagh, and A. R. Farsar, “Celiac disease in children with diarrhea is more frequent than previously suspected,” Journal of Pediatric Gastroenterology and Nutrition, vol. 40, no. 3, pp. 309–311, 2005. View at Publisher · View at Google Scholar · View at Scopus
  9. V. Ertekin, M. A. Selimoglu, F. Kardas, and E. Aktas, “Prevalence of CD in Turkish children,” Journal of Clinical Gastroenterology, vol. 39, pp. 689–691, 2005.
  10. A. Sood, V. Midha, N. Sood, G. Avasthi, and A. Sehgal, “Prevalence of celiac disease among school children in Punjab, North India,” Journal of Gastroenterology and Hepatology, vol. 21, no. 10, pp. 1622–1625, 2006. View at Publisher · View at Google Scholar · View at Scopus
  11. D. A. Nelsen, “Gluten-sensitive enteropathy (celiac disease): more common than you think,” American Family Physician, vol. 66, no. 12, pp. 2259–2266, 2002. View at Scopus
  12. T. S. G. Silva and T. W. Furlanetto, “Diagnosis of celiac disease in adults,” Revista da Associacao Medica Brasileira, vol. 56, no. 1, pp. 122–126, 2010. View at Scopus
  13. J. S. Leeds, A. D. Hopper, and D. S. Sanders, “Coeliac disease,” British Medical Bulletin, vol. 88, no. 1, pp. 157–170, 2008. View at Publisher · View at Google Scholar · View at Scopus
  14. E. Lionetti and C. Catassi, “New clues in celiac disease epidemiology, pathogenesis, clinical manifestations, and treatment,” International Reviews of Immunology, vol. 30, no. 4, pp. 219–231, 2011. View at Publisher · View at Google Scholar · View at Scopus
  15. A. Ferguson and K. Kingstone, “Coeliac disease and malignancies,” Acta Paediatrica, International Journal of Paediatrics, Supplement, vol. 85, no. 412, pp. 78–81, 1996. View at Scopus
  16. J. Cosnes, C. Cosnes, A. Cosnes et al., “Undiagnosed celiac disease in childhood,” Gastroenterologie Clinique et Biologique, vol. 26, no. 6-7, pp. 616–623, 2002. View at Scopus
  17. P. H. R. Green and B. Jabri, “Coeliac disease,” The Lancet, vol. 362, no. 9381, pp. 383–391, 2003. View at Publisher · View at Google Scholar · View at Scopus
  18. M. M. Niewinski, “Advances in Celiac disease and gluten-free diet,” Journal of the American Dietetic Association, vol. 108, no. 4, pp. 661–672, 2008. View at Publisher · View at Google Scholar · View at Scopus
  19. A. Lopez-Vazquez, L. Rodrigo, D. Fuentes et al., “MHC class I chain related gene A (MICA) modulates the development of coeliac disease in patients with the high risk heterodimer DQA10501/DQB10201,” Gut, vol. 50, no. 3, pp. 336–340, 2002. View at Publisher · View at Google Scholar · View at Scopus
  20. V. M. Wolters and C. Wijmenga, “Genetic background of celiac disease and its clinical implications,” American Journal of Gastroenterology, vol. 103, no. 1, pp. 190–195, 2008. View at Publisher · View at Google Scholar · View at Scopus
  21. P. Zubillaga, M. C. Vidales, I. Zubillaga, V. Ormaechea, N. García-Urkía, and J. C. Vitoria, “HLA-DQA1 and HLA-DQB1 genetic markers and clinical presentation in celiac disease,” Journal of Pediatric Gastroenterology and Nutrition, vol. 34, no. 5, pp. 548–554, 2002. View at Publisher · View at Google Scholar · View at Scopus
  22. A. López-Vázquez, D. Fuentes, L. Rodrigo et al., “MHC class I region plays a role in the development of diverse clinical forms of celiac disease in a Saharawi population,” American Journal of Gastroenterology, vol. 99, no. 4, pp. 662–667, 2004. View at Publisher · View at Google Scholar · View at Scopus
  23. A. Lopez-Vazquez, L. Rodrigo, D. Fuentes et al., “MICA-A5.1 allele is associated with atypical forms of celiac disease in HLA-DQ2-negative patients,” Immunogenetics, vol. 53, no. 10-11, pp. 989–991, 2002. View at Publisher · View at Google Scholar · View at Scopus
  24. Å. T. Naluai, S. Nilsson, L. Samuelsson et al., “The CTLA4/CD28 gene region on chromosome 2q33 confers susceptibility to celiac disease in a way possibly distinct from that of type 1 diabetes and other chronic inflammatory disorders,” Tissue Antigens, vol. 56, no. 4, pp. 350–355, 2000. View at Publisher · View at Google Scholar · View at Scopus
  25. D. A. Van Heel, L. Franke, K. A. Hunt et al., “A genome-wide association study for celiac disease identifies risk variants in the region harboring IL2 and IL21,” Nature Genetics, vol. 39, no. 7, pp. 827–829, 2007. View at Publisher · View at Google Scholar · View at Scopus
  26. M. P. Sperandeo, A. Tosco, V. Izzo et al., “Potential celiac patients: a model of celiac disease pathogenesis,” PLoS ONE, vol. 6, no. 7, Article ID e21281, 2011. View at Publisher · View at Google Scholar · View at Scopus
  27. S. Gee, “On the celiac affection,” Saint Bartholomew's Hospital Reports, vol. 24, pp. 17–20, 1988.
  28. L. Pastore, M. De Benedittis, M. Petruzzi et al., “Importance of oral signs in the diagnosis of atypical forms of celiac disease,” Recenti Progressi in Medicina, vol. 95, no. 10, pp. 482–490, 2004. View at Scopus
  29. M. Spina, G. Incorpora, T. Trigilia, F. Branciforte, G. Franco, and F. Di Gregorio, “Headache as atypical presentation of celiac disease: report of a clinical case,” Pediatria Medica e Chirurgica, vol. 23, no. 2, pp. 133–135, 2001. View at Scopus
  30. C. Feighery, “Coeliac disease,” British Medical Journal, vol. 319, no. 7204, pp. 236–239, 1999. View at Scopus
  31. C. Ciacci, M. Cirillo, R. Sollazzo, G. Savino, F. Sabbatini, and G. Mazzacca, “Gender and clinical presentation in adult celiac disease,” Scandinavian Journal of Gastroenterology, vol. 30, no. 11, pp. 1077–1081, 1995. View at Scopus
  32. S. Niveloni, E. Sugai, A. Cabanne et al., “Antibodies against synthetic deamidated gliadin peptides as predictors of celiac disease: prospective assessment in an adult population with a high pretest probability of disease,” Clinical Chemistry, vol. 53, no. 12, pp. 2186–2192, 2007. View at Publisher · View at Google Scholar · View at Scopus
  33. A. Vilppula, K. Kaukinen, L. Luostarinen et al., “Increasing prevalence and high incidence of celiac disease in elderly people: a population-based study,” BMC Gastroenterology, vol. 9, article 49, 2009. View at Publisher · View at Google Scholar · View at Scopus
  34. G. L. Hankey and G. K. T. Holmes, “Coeliac disease in the elderly,” Gut, vol. 35, no. 1, pp. 65–67, 1994. View at Scopus
  35. Y. Lurie, D. A. Landau, J. Pfeffer, and R. Oren, “Celiac disease diagnosed in the elderly,” Journal of Clinical Gastroenterology, vol. 42, no. 1, pp. 59–61, 2008. View at Publisher · View at Google Scholar · View at Scopus
  36. A. Fasano, I. Berti, T. Gerarduzzi et al., “Prevalence of Celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study,” Archives of Internal Medicine, vol. 163, no. 3, pp. 286–292, 2003. View at Publisher · View at Google Scholar · View at Scopus
  37. K. O. Bushara, “Neurologic presentation of celiac disease,” Gastroenterology, vol. 128, no. 4, supplement 1, pp. S92–S97, 2005. View at Publisher · View at Google Scholar · View at Scopus
  38. J. Cheng, T. Malahias, P. Brar, M. T. Minaya, and P. H. R. Green, “The Association between celiac disease, dental enamel defects, and aphthous ulcers in a United States cohort,” Journal of Clinical Gastroenterology, vol. 44, no. 3, pp. 191–194, 2010. View at Publisher · View at Google Scholar · View at Scopus
  39. S. Leonardi, G. Vitaliti, and M. La Rosa, “Recurrent febrile infections and neutropenia in a child with silent celiac disease,” Clinical Pediatrics, vol. 49, no. 2, pp. 146–149, 2010. View at Publisher · View at Google Scholar · View at Scopus
  40. N. Chand and A. A. Mihas, “Celiac disease: current concepts in diagnosis and treatment,” Journal of Clinical Gastroenterology, vol. 40, no. 1, pp. 3–14, 2006. View at Publisher · View at Google Scholar · View at Scopus
  41. M. Viljamaa, K. Kaukinen, H. Huhtala, S. Kyrönpalo, M. Rasmussen, and P. Collin, “Coeliac disease, autoimmune diseases and gluten exposure,” Scandinavian Journal of Gastroenterology, vol. 40, no. 4, pp. 437–443, 2005. View at Publisher · View at Google Scholar · View at Scopus
  42. N. McGough and J. H. Cummings, “Coeliac disease: a diverse clinical syndrome caused by intolerance of wheat, barley and rye,” Proceedings of the Nutrition Society, vol. 64, no. 4, pp. 434–450, 2005. View at Publisher · View at Google Scholar · View at Scopus
  43. G. K. T. Holmes, “Screening for coeliac disease in type 1 diabetes,” Archives of Disease in Childhood, vol. 87, no. 6, pp. 495–499, 2002. View at Publisher · View at Google Scholar · View at Scopus
  44. D. Iafusco, F. Rea, F. Prisco, and J. F. Fitzgerald, “Hypoglycemia and reduction of the insulin requirement as a sign of celiac disease in children with IDDM,” Diabetes Care, vol. 21, no. 8, pp. 1379–1381, 1998. View at Publisher · View at Google Scholar · View at Scopus
  45. O. Kordonouri, A. M. Maguire, M. Knip et al., “Other complications and associated conditions,” Pediatric Diabetes, vol. 8, no. 3, pp. 171–176, 2007. View at Publisher · View at Google Scholar · View at Scopus
  46. E. E. Fröhlich-Reiterer, S. Hofer, S. Kaspers et al., “Screening frequency for celiac disease and autoimmune thyroiditis in children and adolescents with type 1 diabetes mellitus—data from a German/Austrian multicentre survey,” Pediatric Diabetes, vol. 9, no. 6, pp. 546–553, 2008. View at Publisher · View at Google Scholar · View at Scopus
  47. M. Bonamico, A. M. Pasquino, P. Mariani et al., “Prevalence and clinical picture of celiac disease in Turner syndrome,” Journal of Clinical Endocrinology and Metabolism, vol. 87, no. 12, pp. 5495–5498, 2002. View at Publisher · View at Google Scholar · View at Scopus
  48. R. M. Nisihara, L. M. S. Kotze, S. R. R. Utiyama, N. P. Oliveira, P. T. Fiedler, and I. T. Messias-Reason, “Celiac disease in children and adolescents with Down syndrome,” Jornal de Pediatria, vol. 81, no. 5, pp. 373–376, 2005. View at Publisher · View at Google Scholar · View at Scopus
  49. F. Cataldo, V. Marino, A. Ventura, G. Bottaro, and G. R. Corazza, “Prevalence and clinical features of selective immunoglobulin A deficiency in coeliac disease: an Italian multicentre study,” Gut, vol. 42, no. 3, pp. 362–365, 1998. View at Scopus
  50. D. Béchade, J. Desramé, G. De Fuentés, P. Camparo, J. J. Raynaud, and J. P. Algayres, “Common variable immunodeficiency and celiac disease,” Gastroenterologie Clinique et Biologique, vol. 28, no. 10, pp. 909–912, 2004. View at Scopus
  51. K. Lindfors, O. Koskinen, and K. Kaukinen, “An update on the diagnostics of celiac disease,” International Reviews of Immunology, vol. 30, no. 4, pp. 185–196, 2011. View at Publisher · View at Google Scholar · View at Scopus
  52. D. Villalta, E. Tonutti, C. Prause et al., “IgG antibodies against deamidated gliadin peptides for diagnosis of celiac disease in patients with IgA deficiency,” Clinical Chemistry, vol. 56, no. 3, pp. 464–468, 2010. View at Publisher · View at Google Scholar · View at Scopus
  53. C. Prause, T. Richter, S. Koletzko et al., “New developments in serodiagnosis of childhood celiac disease: assay of antibodies against deamidated gliadin,” Annals of the New York Academy of Sciences, vol. 1173, pp. 28–35, 2009. View at Publisher · View at Google Scholar · View at Scopus
  54. D. P. Westerberg, J. M. Gill, B. Dave, M. J. DiPrinzio, A. Quisel, and A. Foy, “New strategies for diagnosis and management of celiac disease,” Journal of the American Osteopathic Association, vol. 106, no. 3, pp. 145–151, 2006. View at Scopus
  55. M. F. Kagnoff, “AGA institute medical position statement on the diagnosis and management of celiac disease,” Gastroenterology, vol. 131, no. 6, pp. 1977–1980, 2006. View at Publisher · View at Google Scholar · View at Scopus
  56. M. N. Marsh, “Gluten, major histocompatibility complex, and the small intestine: a molecular and immunobiologic approach to the spectrum of gluten sensitivity ('celiac sprue'),” Gastroenterology, vol. 102, no. 1, pp. 330–354, 1992. View at Scopus
  57. G. Oberhuber, G. Granditsch, and H. Vogelsang, “The histopathology of coeliac disease: time for a standardized report scheme for pathologists,” European Journal of Gastroenterology and Hepatology, vol. 11, no. 10, pp. 1185–1194, 1999. View at Scopus
  58. G. R. Corazza and V. Villanacci, “Coeliac disease,” Journal of Clinical Pathology, vol. 58, no. 6, pp. 573–574, 2005. View at Publisher · View at Google Scholar · View at Scopus
  59. A. Rostom, J. A. Murray, and M. F. Kagnoff, “American gastroenterological association (AGA) institute technical review on the diagnosis and management of celiac disease,” Gastroenterology, vol. 131, no. 6, pp. 1981–2002, 2006. View at Publisher · View at Google Scholar · View at Scopus
  60. M. Hadjivassiliou, R. Grünewald, B. Sharrack et al., “Gluten ataxia in perspective: epidemiology, genetic susceptibility and clinical characteristics,” Brain, vol. 126, no. 3, pp. 685–691, 2003. View at Publisher · View at Google Scholar · View at Scopus
  61. M. T. Pellecchia, R. Scala, A. Filla, G. De Michelle, C. Ciacci, and P. Barone, “Idiopathic cerebellar ataxia associated with celiac disease: lack of distinctive neurological features,” Journal of Neurology Neurosurgery and Psychiatry, vol. 66, no. 1, pp. 32–35, 1999. View at Scopus
  62. M. Hadjivassiliou, D. S. Sanders, N. Woodroofe, C. Williamson, and R. A. Grünewald, “Gluten ataxia,” Cerebellum, vol. 7, no. 3, pp. 494–498, 2008. View at Publisher · View at Google Scholar · View at Scopus
  63. R. Steele, “for the CRF (Coeliac Research Fund Clinical Advisory Committee Members) Diagnosis and management of coeliac disease in children,” Postgraduate Medical Journal, vol. 87, pp. 19–25, 2011.
  64. C. Lagerqvist, I. Dahlbom, T. Hansson et al., “Antigliadin immunoglobulin a best in finding celiac disease in children younger than 18 months of age,” Journal of Pediatric Gastroenterology and Nutrition, vol. 47, no. 4, pp. 428–435, 2008. View at Scopus
  65. M. Stern, “Comparative evaluation of serologic tests for celiac disease: a European initiative toward standardization,” Journal of Pediatric Gastroenterology and Nutrition, vol. 31, no. 5, pp. 513–519, 2000. View at Publisher · View at Google Scholar · View at Scopus
  66. R. Berger and G. Schmidt, “Evaluation of six anti-gliadin antibody assays,” Journal of Immunological Methods, vol. 191, no. 1, pp. 77–86, 1996. View at Publisher · View at Google Scholar · View at Scopus
  67. J. A. Abrams, B. Diamond, H. Rotterdam, and P. H. R. Green, “Seronegative celiac disease: increased prevalence with lesser degrees of villous atrophy,” Digestive Diseases and Sciences, vol. 49, no. 4, pp. 546–550, 2004. View at Publisher · View at Google Scholar · View at Scopus
  68. W. Dickey, S. A. McMillan, and D. F. Hughes, “Sensitivity of serum tissue transglutaminase antibodies for endomysial antibody positive and negative coeliac disease,” Scandinavian Journal of Gastroenterology, vol. 36, no. 5, pp. 511–514, 2001. View at Scopus
  69. A. Tursi, G. Brandimarte, and G. M. Giorgetti, “Prevalence of antitissue transglutaminase antibodies in different degrees of intestinal damage in celiac disease,” Journal of Clinical Gastroenterology, vol. 36, no. 3, pp. 219–221, 2003. View at Publisher · View at Google Scholar · View at Scopus
  70. S. Kakar, V. Nehra, J. A. Murray, G. A. Dayharsh, and L. J. Burgart, “Significance of intraepithelial lymphocytosis in small bowel biopsy samples with normal mucosal architecture,” American Journal of Gastroenterology, vol. 98, no. 9, pp. 2027–2033, 2003. View at Publisher · View at Google Scholar · View at Scopus
  71. N. Krauss and D. Schuppan, “Monitoring nonresponsive patients who have celiac disease,” Gastrointestinal Endoscopy Clinics of North America, vol. 16, no. 2, pp. 317–327, 2006. View at Publisher · View at Google Scholar · View at Scopus
  72. M. J. Armstrong, G. G. Robins, and P. D. Howdle, “Recent advances in coeliac disease,” Current Opinion in Gastroenterology, vol. 25, no. 2, pp. 100–109, 2009. View at Publisher · View at Google Scholar · View at Scopus
  73. A. Ensari, “Gluten-sensitive enteropathy (celiac disease): controversies in diagnosis and classification,” Archives of Pathology and Laboratory Medicine, vol. 134, no. 6, pp. 826–836, 2010. View at Scopus
  74. T. R. Card, J. West, and G. K. T. Holmes, “Risk of malignancy in diagnosed coeliac disease: a 24-year prospective, population-based, cohort study,” Alimentary Pharmacology and Therapeutics, vol. 20, no. 7, pp. 769–775, 2004. View at Publisher · View at Google Scholar · View at Scopus
  75. J. Schmitz, “Le régime sans gluten chez l’enfant,” Journal de Pédiatrie et de Puériculture, vol. 20, pp. 337–344, 2007.
  76. K. P. Zimmer, “Nutrition and celiac disease,” Current Problems in Pediatric and Adolescent Health Care, vol. 41, no. 9, pp. 244–247, 2011.
  77. D. Schuppan, M. D. Dennis, and C. P. Kelly, “Celiac disease: epidemiology, pathogenesis, diagnosis, and nutritional management,” Nutrition in Clinical Care, vol. 8, no. 2, pp. 54–69, 2005. View at Scopus
  78. E. M. Scott, B. B. Scott, and I. Gaywood, “Guidelines for osteoporosis in coeliac disease and inflammatory bowel disease,” Gut, vol. 46, no. 1, pp. i1–i8, 2000. View at Scopus
  79. A. K. Patwari, V. K. Anand, G. Kapur, and S. Narayan, “Clinical and nutritional profile of children with celiac disease,” Indian Pediatrics, vol. 40, no. 4, pp. 337–342, 2003. View at Scopus
  80. U. Volta, L. De Franceschi, F. Lari, N. Molinaro, M. Zoli, and F. B. Bianchi, “Coeliac disease hidden by cryptogenic hypertransaminasaemia,” The Lancet, vol. 352, no. 9121, pp. 26–29, 1998. View at Publisher · View at Google Scholar · View at Scopus
  81. D. Schuppan, Y. Junker, and D. Barisani, “Celiac disease: from pathogenesis to novel therapies,” Gastroenterology, vol. 137, no. 6, pp. 1912–1933, 2009. View at Publisher · View at Google Scholar · View at Scopus
  82. A. Lerner, “New therapeutic strategies for celiac disease,” Autoimmunity Reviews, vol. 9, no. 3, pp. 144–147, 2010. View at Publisher · View at Google Scholar · View at Scopus
  83. S. Daum, C. Cellier, and C. J. J. Mulder, “Refractory coeliac disease,” Best Practice and Research, vol. 19, no. 3, pp. 413–424, 2005. View at Publisher · View at Google Scholar · View at Scopus
  84. A. Al-Toma, W. H. M. Verbeek, and C. J. J. Mulder, “The management of complicated celiac disease,” Digestive Diseases, vol. 25, no. 3, pp. 230–236, 2007. View at Publisher · View at Google Scholar · View at Scopus
  85. C. Cellier, E. Delabesse, C. Helmer et al., “Refractory sprue, coeliac disease, and enteropathy-associated T-cell lymphoma,” The Lancet, vol. 356, no. 9225, pp. 203–208, 2000. View at Scopus
  86. M. S. Goerres, J. W. R. Meijer, P. J. Wahab et al., “Azathioprine and prednisone combination therapy in refractory coeliac disease,” Alimentary Pharmacology and Therapeutics, vol. 18, no. 5, pp. 487–494, 2003. View at Publisher · View at Google Scholar · View at Scopus
  87. P. J. Wahab, J. B. A. Crusius, J. W. R. Meijer, J. J. Uil, and C. J. J. Mulder, “Cyclosporin in the treatment of adults with refractory coeliac disease—an open pilot study,” Alimentary Pharmacology and Therapeutics, vol. 14, no. 6, pp. 767–774, 2000. View at Publisher · View at Google Scholar · View at Scopus