Celiac disease physical examination: Difference between revisions
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==Physical Examination== | ==Physical Examination== | ||
===Appearance=== | ===Appearance=== | ||
The patient may appear [[pale]] and [[Fatigue|fatigued]]. | The patient may appear [[pale]] and [[Fatigue|fatigued]].<ref>{{cite journal | author = Crabbé P, Heremans J | title = Selective IgA deficiency with steatorrhea. A new syndrome | journal = Am J Med | volume = 42 | issue = 2 | pages = 319-26 | year = 1967 | id = PMID 4959869}}</ref><ref>{{cite journal | author = Collin P, Mäki M, Keyriläinen O, Hällström O, Reunala T, Pasternack A | title = Selective IgA deficiency and coeliac disease | journal = Scand J Gastroenterol | volume = 27 | issue = 5 | pages = 367-71 | year = 1992|id = PMID 1529270}}</ref><ref name=Marks>{{cite journal | author = Marks J, Shuster S, Watson A | title = Small-bowel changes in dermatitis herpetiformis | journal = Lancet | volume = 2 | issue = 7476 | pages = 1280–2 | year = 1966 | id = PMID 4163419}}</ref><ref>{{cite journal | author = Pengiran Tengah D, Wills A, Holmes G | title = Neurological complications of coeliac disease | journal = Postgrad Med J | volume = 78 | issue = 921 | pages = 393-8 | year = 2002 | url = http://pmj.bmjjournals.com/cgi/content/full/78/921/393 | id = PMID 12151653}}</ref> | ||
<ref name=Ferguson>{{cite journal | author = Ferguson A, Hutton M, Maxwell J, Murray D | title = Adult coeliac disease in hyposplenic patients | journal = Lancet | volume = 1 | issue = 7639 | pages = 163-4 | year = 1970 | id = PMID 4189238}}</ref><ref name=Holmes>{{cite journal |author=Holmes G |title=Coeliac disease and Type 1 diabetes mellitus - the case for screening |journal=Diabet Med |volume=18 |issue=3 |pages=169-77 |year=2001 |pmid=11318836}}</ref><ref>{{cite journal | author = Collin P, Kaukinen K, Välimäki M, Salmi J | title = Endocrinological disorders and celiac disease | journal = Endocr Rev | volume = 23 | issue = 4 | pages = 464-83 | year = 2002 | url = http://edrv.endojournals.org/cgi/content/full/23/4/464 | id = PMID 12202461}}</ref><!-- | |||
--><ref>{{cite journal | author = Kingham J, Parker D | title = The association between primary biliary cirrhosis and coeliac disease: a study of relative prevalences | journal = Gut | volume = 42 | issue = 1 | pages = 120-2 | year = 1998|id = PMID 9518232}}</ref> <!-- | |||
--><ref>{{cite journal | author = Matteoni C, Goldblum J, Wang N, Brzezinski A, Achkar E, Soffer E | title = Celiac disease is highly prevalent in lymphocytic colitis | journal = J Clin Gastroenterol | volume = 32 | issue = 3 | pages = 225-7 | year = 2001 | id = PMID 11246349}}</ref> | |||
===Skin/Mucous Membrane=== | ===Skin/Mucous Membrane=== | ||
* [[Dermatitis herpetiformis]] | * [[Dermatitis herpetiformis]] | ||
| Line 20: | Line 22: | ||
*[[stomatitis]] | *[[stomatitis]] | ||
* [[Epistaxis]] | * [[Epistaxis]] | ||
===Abdomen=== | ===Abdomen=== | ||
*[[steatorrhoea|Pale]], voluminous and malodorous [[diarrhoea]]. | *[[steatorrhoea|Pale]], voluminous and malodorous [[diarrhoea]]. | ||
*Hepatosplenomegaly | |||
*[[Abdominal pain]] and cramping | *[[Abdominal pain]] and cramping | ||
*Abdominal distention<ref>{{cite journal | author = Ferguson R, Basu M, Asquith P, Cooke W | title = Jejunal mucosal abnormalities in patients with recurrent aphthous ulceration | journal = Br Med J | volume = 1 | issue = 6000 | pages = 11–13 | year = 1976|id = PMID 1247715}}</ref> . | *Abdominal distention<ref>{{cite journal | author = Ferguson R, Basu M, Asquith P, Cooke W | title = Jejunal mucosal abnormalities in patients with recurrent aphthous ulceration | journal = Br Med J | volume = 1 | issue = 6000 | pages = 11–13 | year = 1976|id = PMID 1247715}}</ref> . | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Common physical examination findings of celiac disease include [finding 1], [finding 2], and [finding 3].
Physical Examination
Appearance
The patient may appear pale and fatigued.[1][2][3][4] [5][6][7][8] [9]
Skin/Mucous Membrane
- Dermatitis herpetiformis
- Alopecia
- Scaly dermatitis
- Easy bruisability
HEENT
Abdomen
- Pale, voluminous and malodorous diarrhoea.
- Hepatosplenomegaly
- Abdominal pain and cramping
- Abdominal distention[10] .
- Increased bowel sounds[11][12]
Musculoskeletal
- Non-specific bone and/or joint pain
- Fractures - Osteopenia
- Tetany
- Decreased range of motion
Neurological
- Peripheral neuropathy(decreased sensations)
Systemic
Miscellaneous
References
- ↑ Crabbé P, Heremans J (1967). "Selective IgA deficiency with steatorrhea. A new syndrome". Am J Med. 42 (2): 319–26. PMID 4959869.
- ↑ Collin P, Mäki M, Keyriläinen O, Hällström O, Reunala T, Pasternack A (1992). "Selective IgA deficiency and coeliac disease". Scand J Gastroenterol. 27 (5): 367–71. PMID 1529270.
- ↑ Marks J, Shuster S, Watson A (1966). "Small-bowel changes in dermatitis herpetiformis". Lancet. 2 (7476): 1280–2. PMID 4163419.
- ↑ Pengiran Tengah D, Wills A, Holmes G (2002). "Neurological complications of coeliac disease". Postgrad Med J. 78 (921): 393–8. PMID 12151653.
- ↑ Ferguson A, Hutton M, Maxwell J, Murray D (1970). "Adult coeliac disease in hyposplenic patients". Lancet. 1 (7639): 163–4. PMID 4189238.
- ↑ Holmes G (2001). "Coeliac disease and Type 1 diabetes mellitus - the case for screening". Diabet Med. 18 (3): 169–77. PMID 11318836.
- ↑ Collin P, Kaukinen K, Välimäki M, Salmi J (2002). "Endocrinological disorders and celiac disease". Endocr Rev. 23 (4): 464–83. PMID 12202461.
- ↑ Kingham J, Parker D (1998). "The association between primary biliary cirrhosis and coeliac disease: a study of relative prevalences". Gut. 42 (1): 120–2. PMID 9518232.
- ↑ Matteoni C, Goldblum J, Wang N, Brzezinski A, Achkar E, Soffer E (2001). "Celiac disease is highly prevalent in lymphocytic colitis". J Clin Gastroenterol. 32 (3): 225–7. PMID 11246349.
- ↑ Ferguson R, Basu M, Asquith P, Cooke W (1976). "Jejunal mucosal abnormalities in patients with recurrent aphthous ulceration". Br Med J. 1 (6000): 11–13. PMID 1247715.
- ↑ Spiegel BM, DeRosa VP, Gralnek IM, Wang V, Dulai GS (2004). "Testing for celiac sprue in irritable bowel syndrome with predominant diarrhea: a cost-effectiveness analysis". Gastroenterology. 126 (7): 1721–32. PMID 15188167. Unknown parameter
|month=ignored (help) - ↑ "American Gastroenterological Association medical position statement: Celiac Sprue". Gastroenterology. 120 (6): 1522–5. 2001. PMID 11313323.
- ↑ Tursi A, Brandimarte G, Giorgetti G (2003). "High prevalence of small intestinal bacterial overgrowth in celiac patients with persistence of gastrointestinal symptoms after gluten withdrawal". Am J Gastroenterol. 98 (4): 839–43. PMID 12738465.