The Clan ThompsonTM Celiac Newsletter
Issue #20 April 21, 2001
Copyright 2001 by Clan
ThompsonTM
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****************************
In this issue:
1. In the News: MOUSE TO MODEL CELIAC
DISEASE
NEW GROUP FOR VEGETARIAN CELIACS
2. Where To Find Gluten Free "Stuff"
3. Announcements: NEW FOOD GUIDE OUT
4. The Cook's Corner: MEATLOAF
5. Take Our True and False Quiz
6. Ask the Doctor: MOTHER OF 7 CELIACS ASKS -
WHAT TEST SHOULD CHILD HAVE?
7. This Month's List: GLUTEN FREE FOODS
8. Around the World
9. Letters From Our Readers
10. Answers to This Month's Quiz
****************************
1. In the News
---
GLUTEN IN PHARMACEUTICAL PRODUCTS
Pharmacists dealing with celiac disease
patients need a reliable means of identifying
the gluten content of pharmaceutical
products.
To read more about this story, visit
Medscape here, but you must be registered
first:
http://gastroenterology.medscape.com/35592.rhtml?srcmp=gas-033001
To register at Medscape:
http://www.medscape.com
---
MOUSE TO MODEL CELIAC DISEASE
Genencor International, Inc., a diversified
biotechnology company that develops and
delivers innovative products into the health
care, agriculture and industrial chemicals
markets, recently announced that it has
achieved a key milestone in the development of
its transgenic mouse model with a mouse line
expressing the human HLA DR3 gene locus.
This model represents the first known in
vivo model that contains the genetically linked
DQ2 and DR3 genes. DQ2:DR3 is the haplotype
most commonly associated with a number of
important autoimmune disorders. The company
also announced today it will, in cooperation
with the Mayo Clinic, use this transgenic mouse
to build an in vivo celiac disease model.
Celiac disease, or as it is also called
sprue, is an autoimmune disorder of the small
bowel associated with gluten or wheat
intolerance. People who express the HLA class
II haplotype DQ2:DR3 are predisposed to several
autoimmune diseases, especially celiac disease,
diabetes, multiple sclerosis, lupus,
thyroiditis, and myasthenia gravis. Transgenic
mice expressing this human gene haplotype have
not been available to generate a mouse disease
model closely resembling the human disease to
study these diseases. The Mayo Clinic and
Genencor will work together to validate this in
vivo autoimmune disease model. Genencor expects
that further collaborations with academia and
industry will be announced.
"It is our belief that by using the new
DR3:DQ2 transgenic mice expressing the entire
human class II haplotype, we can generate new
humanized mouse models simulating the human
disease to understand the mechanism behind the
predisposition, onset, target tissues,
autoantigens and other genes which play a role
in the severity and chronicity of the human
disease," said Michael V. Arbige, senior vice
president of research and development for
Genencor. "Once a disease model is established,
the model can be used to explore new protocols
for immunotherapy, gene therapy and potential
drugs to intervene during various stages of the
disease. We believe this transgenic mouse is a
major advance over currently available mouse
models."
At a recent advisory panel review meeting on
immunology at Genencor's research facility in
Palo Alto, California, the panel assessed the
company's progress in its development of
transgenic mouse technology and identified
several applications for the DQ2:DR3 mouse
model. The panel advised that by using this
model, research could be accelerated and
advanced for several autoimmune diseases,
including celiac and Graves' diseases, type I
diabetes, and multiple sclerosis.
"We were thrilled to see the reception of
our technology by known experts in the field of
immunology, and are very pleased to work with
the Mayo Clinic," Arbige continued. "There are
several near-term opportunities for our DQ2:DR3
mouse model. We will pursue these aggressively
as we continue to develop the full human immune
system in our i-muneTM mouse."
After more than six years in development,
the company now has two effective innovations
within its immunology platform: the i-mune
in-vitro assay and i-mune in-vivo mouse models.
Both developments could transform the
development of biotechnology products by
determining the human body's immunological
response to novel proteins prior to human
testing. These models have broad potential
applications in the development of human
therapeutics, vaccines and consumer
products.
While there are many uses for Genencor's HLA
mouse model, the company's ultimate goal is to
develop the full human immune system in a
mouse. Genencor has identified human genes
believed to be key to the development of a
human immune system in immunodeficient mice.
The company has established transgenic lines of
mice expressing these genes and is evaluating
their ability to support the engraftment of
human hematopoetic stem cells. Genencor's
humanized i-mune mouse will be a breakthrough
in the ability to study and develop new
treatments for diseases of the human immune
system such as HIV, and will further advance
research of genetically-linked autoimmune
diseases, like multiple sclerosis or type I
diabetes. The mouse will also be used to study
and potentially avert organ rejection following
transplants, and significantly improve the
ability to characterize and manipulate human
hematopoietic stem cells.
As the second arm in its immunology arsenal,
Genencor has developed its i-mune assay, an in
vitro predictive immunological test that
recreates the initial steps of a human immune
response. This revolutionary test is an epitope
mapping system that identifies portions of a
protein that are likely to prime the immune
system in naïve, or unexposed,
individuals. Once an epitope is identified,
Genencor can engineer that portion of the
protein to significantly reduce activation of
an adverse immune response. Alternatively, it
can strengthen the response to a pathogenic
epitope to induce protective immunity. This
will have application in human therapeutics,
vaccines and consumer products such as personal
care, as well as in the testing of agricultural
biotechnology products.
---
NEW GROUP FORMS FOR VEGETARIAN CELIACS
(Editor's Note: Aviva Mandl has formed a new
group for vegetarian celiacs. If you'd like to
read about her struggle with celiac disease,
you can visit her website at
www.mandlmedia.com/aviva/fall.html.)
Clan Thompson: Would you tell our readers
something about yourself and who you are?
Aviva: I'm a 31-year-old single woman living
in the Chicago area. I do any type of
consulting work (graphic/web
design/writing/editing or public relations) I
can do from home. I spent many years getting
constantly sick and as a result, developed
severe Panic Disorder and Agoraphobia. Now that
I've been following the gluten-free diet, I'm
finally not constantly sick and am working on
being able to get further out of my home. My
improved health makes me feel like a kid in a
candy store who has so many colorful and
interesting choices available, I'm unsure which
to try first. *chuckle*
Clan Thompson: Why did you decide to start a
celiac-vegetarian group?
Aviva: My mother says she thinks I've been
getting ready to follow a gluten-free diet for
many years. I decided to keep Kosher when I was
17 and when I was 20, elimination diets after a
gallbladder surgery kept pointing to
meat/poultry as a cause of me getting sick, so
I became a vegetarian. When I first found out
about following a gluten-free diet back in
December of 1999, I wondered how I would be
able to remain a vegetarian when all of my
staples were now off limits. I received a lot
of help from the Celiac Listserv. I added eggs,
some dairy (I'm lactose intolerant) and even a
bit of fish back into my diet because I was
afraid I wouldn't be getting proper nutrition.
It's taken me awhile to get comfortable with
the diet and I figured there are probably
others out there who are vegetarians or vegans
or even just those that would like to add more
vegetarian/vegan dishes to their menus. I
decided to start a Vegetarian & Gluten-Free
group to reach these people. I still love the
main Celiac Listserv, but I feel that we as
vegetarians and vegans have different needs
that may not always get addressed: proper
nutrition on a vegetarian/vegan diet, quick
meals/recipe ideas and especially - important
to me for sure - finding out about more meat
substitutes that are gluten-free.
Clan Thompson: Do you find it difficult to
be a vegetarian celiac?
Aviva: At the beginning I definitely found
keeping to both a vegetarian and gluten-free
diet more challenging, but I was willing to do
anything to feel better. At one point, I begged
my gastroenterologist for a list of 10 foods
that I could eat without getting sick. To find
out that all I needed to do was eliminate
gluten and I could feel better? That I have the
prospect of living a complete life if I just
get rid of gluten? As much as I loved pizza, I
just cut it out. What's more difficult for me
is not the prospect of keeping on the
vegetarian diet, but of keeping on the
gluten-free diet. I'm tempted more by a slice
of deep dish Chicago pizza or freshly made
challah at local Kosher bakeries so much more
than I am by meat or poultry. But I think about
just how poorly I'd feel if I had the pizza or
challah, and just try to substitute what I can
have.
Thankfully, there are just so many wonderful
companies that are catering to our needs. I
really don't feel like I'm missing out. I may
have lost the ease I had, but considering I
couldn't enjoy life with the ease - what did I
really have anyway? I think the answer is in
trying to keep things simple. I have purchased
foods I can keep in the freezer and microwave
when I don't have time to cook, I eat a lot of
fresh fruits and vegetables. When I cook, I
make double or triple the amount I normally
would so I have meals for a few days and/or
some food to freeze to eat at a later time.
Some simple planning helps a great deal.
Clan Thompson: What's the official name of
the group? It's purpose?
Aviva: The group is called the Vegetarian
∓ Gluten-Free group. The only real
requirement is that people should be following
a gluten-free diet. I've received emails from
people looking to cut their cholesterol levels
by adding more vegetarian/vegan dishes to their
menus and I think the group can be helpful even
for those who aren't completely vegetarian or
vegan. I would request that only
vegetarian/vegan recipes be posted to the
group. I won't tell anyone they shouldn't eat
meat or preach about saving animals, being a
vegetarian or vegan a personal choice and it's
not for everyone, but this group is geared for
dishes/nutrition/information to vegetarians or
vegans. I would really like to see the group
grow and continue to fill the needs of the
community. We can help each other put together
menus, modify favorite dishes and just share
information.
Clan Thompson: Who can join?
Aviva: Anyone who follows a gluten-free or
wheat-free diet would be welcome. Obviously,
the person would have some interest in a
vegetarian or vegan diet, but that's not a
requirement to joining. I know some have
children who are vegetarians and vegans and may
want to get ideas for foods for them or others
looking for some alternative dishes.
Clan Thompson: How can someone join this
group?
Aviva: Anyone interested can go the website
at http://groups.yahoo.com/group/vegetariangf
There's an area to sign up there or one can
join by sending an email to
vegetariangf-subscribe@yahoogroups.com
Clan Thompson: Do you have any good books to
recommend for CV's? Good websites? Other
resources?
Aviva: Unfortunately, I don't know of any
books offhand. Maybe I'll write one. *chuckle*
There are many links I've listed in the
Bookmark section on the website that link to
some excellent Celiac sources of information
and Vegetarian/Vegan sources of information.
Unfortunately, I have not found many where the
two are combined.
Clan Thompson: What do other celiac
vegetarians tell you they "need" most?
Aviva: The group is too new to be able to
answer this yet. However, most have expressed a
need was for this group and their happiness to
join and be a part of it.
Clan Thompson: What one bit of advice do you
have for celiac vegetarians?
Aviva: If it's important to you to follow a
vegetarian diet, it can be done. I think it
makes following the gluten-free diet easier
because we're already used to restricting our
diets. When you're watching ingredients and
processing to make sure products don't contain
animal products, you are that much closer to
being able to follow a gluten-free diet. And
the same is true in reverse. If you've managed
to cut out gluten - which I personally feel is
more difficult than vegetarian or vegan diet -
removing animal products would be that much
easier.
Clan Thompson: Anything you'd like to
add?
Aviva: More than the issues of is it "right
or wrong" to eat animal products, I think we
need to be thinking of our health foremost. We
come from generations of cancer, of heart
disease, of other deadly diseases that in part
can be linked to our food consumption. We
remove the gluten to prolong our lives and even
substituting just a few vegetarian or vegan
meals in place of meat/poultry meals can do
wonders for our health. It lowers our
cholesterol and gives us the opportunities to
establish new healthier traditions with the
families we will be able to spend more time
with in the long run.
****************************
2. WHERE TO FIND GLUTEN FREE "STUFF"
---AD: GLUTEN SOLUTIONS ---
When was the last time you shopped at a store
where everything was gluten-free? If you've
never seen such a store, then Gluten Solutions
can help. We stock products from 31 different
gluten-free manufacturers, and ship them via
USPS or UPS right to your front door. You can
read customer reviews on each product BEFORE
YOU BUY, and you choose the shipping option
that suits you. Because of our wide selection
and speedy shipping, you'll have a kitchen
stocked full of great gluten-free foods in no
time.
At Gluten Solutions, we only do gluten-free.
Give us a try at
http://www.glutensolutions.com
---AD: CECILIA'S GLUTEN-FREE GROCERY---
Our New Products:
Ener-G Foods Tapioca Hamburger Buns
(F-4115)
Ener-G Foods Tapioca Hotdog Buns (F-4135)
Ener-G Foods Brown Rice English Muffins SOFT!
(F-4145)
(See these muffins in our Baked Products
aisle)
Our product list is now available for viewing
and printing from our Web site. You can print
the order form too! Just go to our home page
and click on the button at the bottom that says
Click Here For Quick View Product
List.
Please shop online for our latest additions of
great gluten-free products and ongoing
promotions!
Click here to begin shopping:
http://www.glutenfreegrocery.com/ Then click on
the Shop Now button
Happy Shopping!
---END OF ADS---
****************************
3. Announcements
----- CLAN THOMPSONTM POCKET GUIDE TO GLUTEN-FREE
FOODS 2001
Our new pocket guide is out. A lot of
manufacturers either discontinued their gluten
free lists this year or have updated their old
lists, so much of the information in our old
guide is now out of date. Information in this
year's guide was verified directly with each
manufacturer between February 9 and April 4,
2001 and we've included hundreds of (mostly)
toll free numbers so you can call manufacturers
yourself.
Like our other guides, this guide fits right
into your pocket or purse for handy referencing
during shopping.
For more info, visit our webpage at
www.clanthompson.com
TO ORDER: Send a check or money order for
$4.50 to Clan Thompson TM, 951 Maine St., Stoneham, ME
04231.
---
GIG ANNUAL CONFERENCE
GIG will hold its annual conference on June 2
and 3 at the University of Puget Sound in
Tacoma Washington. Health screenings will be
offered this year including celiac screenings,
genetic screenings for families with 2 or more
biopsy-proven persons with CD or DH, Diabetes
screenings, and bone density screenings.
Attendees, family members, and the public are
encouraged to participate. Fees have been kept
low.
Among the speakers this year are Margaret
Fowler, RPh (Choosing Medications For Your
Child), Dr. Daniel Kalish (Using Holistic
Medicine with Gluten Intolerances), Shelley
Case, B.Sc. (Nutr.) RD (The New Dietary
Guidelines for the Gluten Free Diet), Ann
Whelan (What the 21st Century Holds for
Celiacs), Mildred I. Gartin, ATMG (Life's
Lessons), Kathleen Putnam, RD (Genetically
Engineered Foods), Kelly Morrow, RD (Cooking
with Amaranth, Quinoa, Buckwheat and other
Exotic Grains), Suzzanne Myer, RD (Gluten-Free,
Casein-Free Diet), Margaret Fowler, RPh
(Pharmacy Secrets), Cindy Hylton, DMD (Healthy
Smiles with Celiac Disease), Dr. Peter Hartwell
(Overview of Celiac Disease - main program) and
Danna Korn (Your Celiac Kids ARE Different -
And That's OKay) and Cynthia Kupper (Let's Talk
Diet).
The cost for this conference varies depending
on whether you are a commuter ($145/members,
$170/non members) or whether you are a resident
with room and board ($270/members, $295/non
members). Family rates are available, too.
For more info call GIG at 206-246-6652.
---
SEND US YOUR NEWS AND ANNOUNCEMENTS... News
should be of national or international
interest. We're sorry, but space requirements
mean we can't list announcements about local
support group meetings. Send your news to
observer@nxi.com The phrase "Celiac News" or
"Celiac Announcement" should appear in the
subject line.
****************************
6. The Cook's Corner: MEATLOAF
-----
This month's recipe comes from Clan
ThompsonTM. We don't
mind if you share it, but it may not be
reprinted in any publication without written
permission and if you make any copies, this
notice must be attached.
---
MEATLOAF
1 cup gluten free bread crumbs
1 onion, chopped and lightly fried
1 egg, slightly beaten
1 Tablespoon of gluten free soy sauce
3/4 tsp. dry mustard
1/4 tsp. garlic powder
1/4 tsp. salt
1/4 tsp. black pepper
1/4 cup milk
1 lb. ground beef
Mix all the ingredients together in a large
bowl. Place into a greased pan. Bake in a
preheated 350 degree oven for about one hour.
If you want leftovers for meatloaf sandwiches,
you may want to double the amounts!
***************************
7. True or False: Take our Quiz
---
The answers to our quiz can be found at the
end of our newsletter but, before you peek, see
if you can find the answers yourself in Ask the
Doctor.
---
1. Rashes are a common occurrance in
patients with celiac disease and most of the
time the rash is NOT DH. T or F 2. A mouse
bioengineered to have celiac disease may help
researchers develop new treatments including
drugs and gene therapy. T or F
3. Starkist tuna contains gluten. T or F
4. A diagnosis of celiac disease can be made
entirely with a blood test. T or F
5. One can have a positive biopsy with
negative blood testing. T or F
****************************
8. Ask the Doctor
Dr. Cynthia S. Rudert, M.D., F.A.C.P. is a
Board Certified Gastroenterologist, the Medical
Director for the Gluten Sensitive Support Group
of Atlanta, a medical advisor for the Gluten
Intolerance Group of North America, and she has
one of the largest practices devoted to Celiac
Disease in the United States.
-----
Please send your celiac-related medical
question to observer@nxi.com . The phrase "Ask
the Doctor" MUST appear in the subject line.
Responses generally take 1-2 months.
-----
Dear Dr. Rudert,
I am the mother of 7 children. My 10 year old
son was first diagnosed with CD through a small
intestine biopsy. The other 6 children were
given blood test. 5 of the 6 test came back
with high IgG levels. Our GI told me to put
them all on the GF diet because he believed
they all had it. My 11 year old son, who has
Aspergers and many other problems, tested
negative with his blood work but so did my 10
year old who's biopsy was positive. I tested
negative also. We have been on a Gluten Free
Diet for several months and we all can tell a
big difference. However, I don't feel our
medical needs are being address and I was
hoping you could help me with this. Our GI does
not want to do any repeat test. He has not
tried to find out if we are lacking any
vitamins or minerals in our diet and the only
plan he has to look at us every 4 months, for
what I don't know. Here is the question: What
test or maintenance should a celiac child have?
I would love to bring them all to Atlanta, we
live in Mississippi, if you could see us all at
once. Please advise. I don't feel my children
are getting the best possible medical
treatment. Thank you, B.B.
---
Dear B. B.
I was absolutely amazed to receive your
letter. Obviously Celiac Disease may run in
families although I have never heard of a mom
with seven Celiac children! Please be sure that
the children's father is tested.
It is always preferable to have a small bowel
biopsy prior to diagnosing Celiac Disease.
Serologic testing may lead one to strongly
expect the diagnosis; however, all the experts
agree that blood testing is not to the point
where it can replace a small bowel biopsy.
I am limited in training to adult
gastroenterology; however, I do see children as
young as fourteen. In fact, recently I saw a
Celiac mom whose son may have Aspergers (his
blood and small bowel biopsy were negative). As
you indicate from your letter one can certainly
have a positive biopsy with negative blood
testing. It is estimated that 20% of
individuals with Celiac may be seronegative.
You mentioned in your letter that your blood
test was negative.
Fortunately, you are all doing better on a
gluten-free diet. I generally screen all
patients for vitamin B12 and folic acid
deficiency (with B12 levels and rbc folate
levels) in addition to routine labs screening
for anemia, diabetes, liver disease and
coagulation problems if indicated. I also
routinely obtain serum IgA levels. Ten to
Twenty percent of patients may be IgA
deficient, which may explain why some of the
Celiac testing may be "negative" (antiagliadin
IgA and antiendomysial antibody ab and ttg IgA
are dependent on appropriate IgA levels to be
elevated). Also, IgA deficiency may predispose
individuals to recurrent infections such as
giardiasis which is a microscopic intestinal
parasite.
I am flattered that you would think to bring
everyone to Atlanta; however, first I would
recommend a new book that has just been
released titled, Kids with Celiac Disease by
Danna Korn. Mrs. Korn has a Celiac child and
was the founder of a support group she named
"Raising Our Celiac Kids" (R.O.C.K.). You need
to have everyone on gluten-free multi-vitamins
and Twin Labs makes an excellent extremely
complete chewable vitamin for children. I would
also recommend subscribing to "Sully's Living
Without" magazine (www.livingwithout.com).
Their address is: P. O. Box 132, Clarendon
Hills, IL 60514-0132 or call (630) 415-3378. I
also learn a lot from the publication
Gluten-Free Living and subscriptions may be
ordered by contacting them at their address:
Gluten-Free Living, P. O. Box 105,
Hastings-on-Hudson, N.Y. 10706. I encourage my
patients to join as many of the support groups
as possible and they are listed below:
Celiac Disease Foundation
13251Ventura Blvd., Suite 1
Studio City, CA 91604
Phone: 818-990-2354
Webside: www.celiac.org
Celiac Sprue Association/
United States of America (CSA/USA)
P. O. Box 31700
Omaha, NE 68131
Phone: 402-558-0600
Website: www.csaceliacs.org
Gluten Intolerance Group of
North America
15110 10th Ave., S.W.
Seattle, WA 98166
Phone: 206-246-6652
Sincerely,
Cynthia S. Rudert, M.D., F.A.C.P.
---
Dear Dr. Rudert,
The New Haven Group did a blood screening
mostly for first and second degree relatives in
December and tested 170 people - 99 who were
first and second degree relatives. The others
were 27 for compliance and non-celiacs with
symptoms. We are looking for good info on
interpreting these tests. Do you have any
suggestions?
Jane
---
Dear Jane,
One must be very cautious when interpreting
blood tests for Celiac Disease in first and
second degree relatives since a diagnosis
cannot be made or excluded entirely based on
blood testing. Twenty (20%) percent of Celiacs
may be seronegative and obviously if an
individual, especially a first degree relative,
has symptoms a small bowel biopsy should be
considered. The incidence of Celiac Disease is
estimated to be one in twelve in first degree
relatives based on Dr. Alessio Fassano's yet to
be published serologic prevalence study. There
is also a subset of individuals I have seen
with a variety of symptoms that have negative
bloods and normal biopsies that respond to a
gluten-free diet. Obviously these individuals
are not Celiac, but are gluten sensitive.
Sincerely,
Cynthia S. Rudert, M.D., F.A.C.P.
---
Dear Dr. Rudert,
My husband was diagnosed with CD nearly 2
years ago and he has been GF ever since with
the exception of a couple of accidental
ingestions. He is feeling much better except
for one thing that may or may not be celiac
related. He has been plagued with itching over
most of his body, sometimes accompanied with a
terrible rash. He has seen numerous doctors
over the years -- allergists, dermatologists,
gastroenterologist for the GI symptoms, family
practitioners for general medicine -- and no
one has been able to pinpoint the problem or
cure the itching. One doctor told him he
thought he was allergic to his own
perspiration. He has had a rash ever since he
was a little boy(at that time they just called
it prickly heat or heat rash), but the GI
symptoms did not develop until he was around
42. It took about 15+ years to be correctly
diagnosed wth CD. The longer he is on the GF
diet, the rash seems to be getting better,
however, the itching persists, most of the time
not as bad as before going GF.
Along the way, he was tested for numerous
allergies and takes allergy injections for
ragweed and grasses, etc. He did test slightly
positive for some food allergies but we were
told they were so slight that it was not
necessary to avoid them. Last week, we saw yet
another dermatologist for the rash on his
scalp, neck, back, chest, and arms. We thought
that possibly he had DH even though the rash
does not look like the pictures we have seen.
The fact that it seems to be getting better the
longer he is GF seemed to give a clue. He also
reacted to a shampoo that contained wheat germ.
DH seemed to make sense to us. We, therefore,
eliminated all topical products that contain
gluten. The dermatologist said that from what
she could see, it was not a classic case of DH,
but it could still be DH. She said there was no
lesion to biopsy, so a biopsy would be
worthless. There would be no point to doing a
biopsy on his rash. The rash looks like raised
red bumps that sometimes resemble a pimple. She
says she thinks there are several things going
on from eczema on his arms to seborrhea on his
scalp and gave him 5 different prescriptions --
shampoo and another solution for his scalp, an
ointment for his arms, a lotion for his back
and pills for the intense itching. She also
recommended that we use free and clear laundry
soaps, bath soaps, deodorants, etc.
We have made the suggested changes -- most of
which we were already doing. We are so
frustrated at this point. He continues to itch
-- even on his legs and feet where there is no
rash at all. The pill that she gave him for
itching puts him to sleep immediately, so I
guess we should be grateful for that because we
can both get some sleep anyway. My question is
whether itching and rashes are a common
occurrence with CD patients. Do you have
patients with these problems and what do you
recommend? Are we on the right track with a
dermatologist or should we be seeing an
allergist or another type of doctor? I know it
is difficult for you to give an opinion without
really seeing the rash, but we would really
appreciate your input. Maybe this is not CD
related at all and we are looking in the wrong
direction. Thank you for your help.
Barbara
---
Dear Barbara:
Rashes, indeed, are a common occurrence in
patients with Celiac Disease. The majority of
the time the rash is not DH; however,
individuals must remember in order to correctly
diagnose DH, a skin biopsy must be obtained
from the normal skin adjacent to the lesion.
Generally, DH takes longer to resolve than the
small bowel abnormalities on a gluten-free
diet. DH may take six months or longer. I would
recommend that all topical products such as
shampoos, lotions and creams be gluten-free
(although others may not agree with me). I
recently had an individual with a long-standing
severely itchy rash that we determined was on
the basis of an underlying infection called H.
Pylori. This is a bacteria that invades the
lining of the stomach and if present can be
treated with appropriate antibiotic therapy.
After treatment, her rash of over 15 years
spontaneously resolved. Co-incidentally, she
also had an occult (hidden) dental abscess. A
repeat endoscopy could re-evaluate his Celiac
status (with small bowel biopsies) and gastric
biopsies could also be obtained looking for H.
Pylori. Blood testing could be obtained as an
initial screen; however, it is not as sensitive
as endoscopy. I would also recommend repeat
Celiac antibodies. I hope this helps. Please
let me know if he gets better.
Sincerely,
Cynthia S. Rudert, M.D., F.A.C.P.
****************************
9. This Month's List: GLUTEN FREE FOODS
---
All of the foods in this month's list are
gluten free. The information was verified
within the last thirty days. We've included the
manufacturer's phone number if you'd like to
call them.
Manufacturer: 1-888-550-9555
Smuckers Jams (all flavors)
Smucker's Jellies (all flavors)
Manufacturer: 1-800-626-3932 x 662
Dairy Ease 100 (2% milk)
Manufacturer: 1-800-851-0512
Carnation Instant Breakfast Ready to Drink
(all flavors)
Carnation Instant Nonfat Dry Milk
Manufacturer: 1-800-527-7096
A ∓ W Root Beer
Orange Crush (regular and diet)
Schwepp's Ginger Ale (regular and diet)
Manufacturer: 1-800-252-1587
Starkist Tuna
Manufacturer: 1-800-410-7687
Swanson Premium Chunck Chicken (3 oz. can)
Manufacturer: 1-800-410-7687
Campbell's Chunky Chichen Broccolli Cheese
Soup
Campbell's Tomato Juice 5 12/ oz/6 UPC CODE:
51000000071
Manufacturer: 1-800-824-3373
Frigo Label Provolone Slices
Frigo Label Mozzarella Shred
Frigo Label Chedar Shred
Frigo Label String Cheese
Manufacturer:1-800-256-2253
Heartline Meatless Meats: Ground Beef (8
oz.)
Heartline Meatless Meats: Canadian Bacon (8
oz.)
Heartline Meatless Meats: Italian Sausage (8
oz.)
Manufacturer: 1-800-LACTAID
Lactaid 70
Manufacturer: 1-800-735-3610
Shed's Vegetable Oil Spread
Imperial Vegetable Oil Spread
Manufacturer: 1-800-244-4596
Jet Puffed Marshmallows
Jet Puffed Marshmallow Creme
Manufacturer: 1-800-297-5997
Hearty ∓ Natural Veggie Burger
Patties
Hearty ∓ Natural Veggie Chick-N
Manufacturer: 1-800-225-0601
Cain's Tartar Sauce
Cain's All Natural Mayonaisse
Manufacturer: 1-800-456-9573
Betty Crocker Neon Decorating Gels
****************************
10. Around the World
-----
How do celiacs live in Ireland, Spain, Sweden,
the Ukraine or other countries? Is it easy to
find safe food? How knowledgeable are the
doctors? What kind of support groups exist?
We're looking for people who want to share
their experiences with our readers. Short
articles of about a few hundred words can be
sent to us at observer@nxi.com
****************************
11. Letters From Our Readers
Send your comments, questions, or suggestions
to us at observer@nxi.com. We want to hear from
you!
---
Dear Clan and Lani,
....I really enjoy your newsletter and often
read it as soon as it comes in no matter how
late it is....(G.P.)
****************************
12. Answers to the True and False Quiz
1) True
2) True
3) False
4) False
5) True
****************************
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