Celiac disease medical therapy: Difference between revisions

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*2. Pharmocatherapy<ref name="pmid12477369">{{cite journal |vauthors=Collin P, Reunala T |title=Recognition and management of the cutaneous manifestations of celiac disease: a guide for dermatologists |journal=Am J Clin Dermatol |volume=4 |issue=1 |pages=13–20 |year=2003 |pmid=12477369 |doi= |url=}}</ref>
*2. Pharmocatherapy<ref name="pmid12477369">{{cite journal |vauthors=Collin P, Reunala T |title=Recognition and management of the cutaneous manifestations of celiac disease: a guide for dermatologists |journal=Am J Clin Dermatol |volume=4 |issue=1 |pages=13–20 |year=2003 |pmid=12477369 |doi= |url=}}</ref>
*2.1 Sulfones
*2.1 Sulfones
*:::* Preferred treatment(1):Dapsone 25-300 mg q24h
*::* Preferred treatment(1):Dapsone 25-300 mg q24h
*2.2 Suhphonamides
*2.2 Suhphonamides
*:::* Alternative treatment (1): Sulfapyridine 500 mg to 3 g q24h
*::* Alternative treatment (1): Sulfapyridine 500 mg to 3 g q24h


==References==
==References==

Revision as of 15:18, 13 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]

Overview

Preferred therapy for celiac disease is dietary modification which includes gluten-free diet. Patients with celiac disease should be referred to a dietitian once the diagnosis of celiac disease is made. A minority of patients suffer from refractory disease, which means that they do not improve with a gluten-free diet. Pharmocotherapy is used if alternative causes are eliminated and dietary modification is not beneficial. Pharmacotherapy include steroids, azathioprine, cyclosporin, and monoclonal antibodies.

Medical Therapy

Refractory disease

A tiny minority of patients suffer from refractory disease, which means they do not improve on a gluten-free diet. This may be because the disease has been present for so long that the intestines are no longer able to heal on diet alone, or because the patient is not adhering to the diet, or because the patient is consuming foods that are inadvertently contaminated with gluten. Pharmocotherapy is used if alternative cause is elimiated.[1]

  • 1 Steroids
  • 2 Immunosupressive drugs (Used in steroid dependent or steroid refractory disease)
    • 2.1 Antiproliferative agents
    • 2.2 Calcineurin Inhibitors:
    • 2.3 Monoclonal antibodies
  • Preferred regimen(1): Infliximab 5 mg/kg q24h
  • Preferred regimen(2): Alemtuzumab 30 mg twice a week per 12 weeks

Dermatitis herpetiformis

  • 1. Life style modification[2]
    • 1.1 Gluten-free diet (GFD)
  • 2. Pharmocatherapy[2]
  • 2.1 Sulfones
    • Preferred treatment(1):Dapsone 25-300 mg q24h
  • 2.2 Suhphonamides
    • Alternative treatment (1): Sulfapyridine 500 mg to 3 g q24h

References

  1. Rubio-Tapia A, Murray JA (2010). "Classification and management of refractory coeliac disease". Gut. 59 (4): 547–57. doi:10.1136/gut.2009.195131. PMC 2861306. PMID 20332526.
  2. 2.0 2.1 Collin P, Reunala T (2003). "Recognition and management of the cutaneous manifestations of celiac disease: a guide for dermatologists". Am J Clin Dermatol. 4 (1): 13–20. PMID 12477369.

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