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Beyond moulage sign and TTG levels: the role of cross-sectional imaging in celiac sprue.
Abdom Radiol (NY) 2017; 42(2):361-388AR

Abstract

Celiac disease is an autoimmune disorder that causes inflammation and destruction in the small intestine of genetically susceptible individuals following ingestion of gluten. Awareness of the disease has increased; however, it remains a challenge to diagnose. This review summarizes the intestinal and extraintestinal cross-sectional imaging findings of celiac disease. Small intestine fold abnormalities are the most specific imaging findings for celiac disease, whereas most other imaging findings reflect a more generalized pattern seen with malabsorptive processes. Familiarity with the imaging pattern may allow the radiologist to suggest the diagnosis in patients with atypical presentations in whom it is not clinically suspected. Earlier detection allows earlier treatment initiation and may prevent significant morbidity and mortality that can occur with delayed diagnosis. Refractory celiac disease carries the greatest risk of mortality due to associated complications, including cavitating mesenteric lymph node syndrome, ulcerative jejunoileitis, enteropathy-associated T cell lymphoma, and adenocarcinoma, all of which are described and illustrated. Radiologic and endoscopic investigations are complimentary modalities in the setting of complicated celiac disease.

Authors+Show Affiliations

Department of Radiology, Mayo Clinic, 200 First Street, S.W., Rochester, MN, 55905, USA. sheedy.shannon@mayo.edu.Department of Radiology, Mayo Clinic, 200 First Street, S.W., Rochester, MN, 55905, USA.Department of Radiology, Mayo Clinic, 200 First Street, S.W., Rochester, MN, 55905, USA.Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.Department of Radiology, Lahey Clinic, Burlington, MA, USA.Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.Department of Radiology, Mayo Clinic, 200 First Street, S.W., Rochester, MN, 55905, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

28154909

Citation

Sheedy, Shannon P., et al. "Beyond Moulage Sign and TTG Levels: the Role of Cross-sectional Imaging in Celiac Sprue." Abdominal Radiology (New York), vol. 42, no. 2, 2017, pp. 361-388.
Sheedy SP, Barlow JM, Fletcher JG, et al. Beyond moulage sign and TTG levels: the role of cross-sectional imaging in celiac sprue. Abdom Radiol (NY). 2017;42(2):361-388.
Sheedy, S. P., Barlow, J. M., Fletcher, J. G., Smyrk, T. C., Scholz, F. J., Codipilly, D. C., ... Fidler, J. L. (2017). Beyond moulage sign and TTG levels: the role of cross-sectional imaging in celiac sprue. Abdominal Radiology (New York), 42(2), pp. 361-388. doi:10.1007/s00261-016-1006-2.
Sheedy SP, et al. Beyond Moulage Sign and TTG Levels: the Role of Cross-sectional Imaging in Celiac Sprue. Abdom Radiol (NY). 2017;42(2):361-388. PubMed PMID: 28154909.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Beyond moulage sign and TTG levels: the role of cross-sectional imaging in celiac sprue. AU - Sheedy,Shannon P, AU - Barlow,John M, AU - Fletcher,Joel G, AU - Smyrk,Thomas C, AU - Scholz,Francis J, AU - Codipilly,Don C, AU - Al Bawardy,Badr F, AU - Fidler,Jeff L, PY - 2017/2/6/pubmed PY - 2018/3/20/medline PY - 2017/2/4/entrez KW - Celiac disease KW - Celiac sprue KW - Refractory celiac disease KW - Refractory sprue KW - Small bowel disease KW - Small bowel enterography SP - 361 EP - 388 JF - Abdominal radiology (New York) JO - Abdom Radiol (NY) VL - 42 IS - 2 N2 - Celiac disease is an autoimmune disorder that causes inflammation and destruction in the small intestine of genetically susceptible individuals following ingestion of gluten. Awareness of the disease has increased; however, it remains a challenge to diagnose. This review summarizes the intestinal and extraintestinal cross-sectional imaging findings of celiac disease. Small intestine fold abnormalities are the most specific imaging findings for celiac disease, whereas most other imaging findings reflect a more generalized pattern seen with malabsorptive processes. Familiarity with the imaging pattern may allow the radiologist to suggest the diagnosis in patients with atypical presentations in whom it is not clinically suspected. Earlier detection allows earlier treatment initiation and may prevent significant morbidity and mortality that can occur with delayed diagnosis. Refractory celiac disease carries the greatest risk of mortality due to associated complications, including cavitating mesenteric lymph node syndrome, ulcerative jejunoileitis, enteropathy-associated T cell lymphoma, and adenocarcinoma, all of which are described and illustrated. Radiologic and endoscopic investigations are complimentary modalities in the setting of complicated celiac disease. SN - 2366-0058 UR - https://www.unboundmedicine.com/medline/citation/28154909/Beyond_moulage_sign_and_TTG_levels:_the_role_of_cross_sectional_imaging_in_celiac_sprue_ L2 - https://dx.doi.org/10.1007/s00261-016-1006-2 DB - PRIME DP - Unbound Medicine ER -