If she has wheat (gluten) allergy, she should not take wheat again, it will damage her intestines further and put he at risk for auto immune diseases. She can take gluten free grains like rice, ragi, nachni, bajra, rajgira.
agreed with dr Anukalp. No point in prescribing gluten free diet to this child. if biopsy is nornal, then you should look for other causes of iron deficiency anemia most notably worms or thalassemia trait.
thanks dr lily and dr karthiak for your valuable time and suggestions. I will definitely work up on case and let you know.problem is she has no interest in other grains. As her parents told me that they have not stopped gluten diet for 2 yrs and she is doing well . they don't understand the pathological changes going on in intestine. how to advice them is a big practical question
She is having microcytic hypochromic anaemia with slightly elevated RDW. Kindly evaluate her for iron deficiency anaemia and hemoglobin HPLC for underlying hemoglobinopathy..
The child doesn't know what's good for her. Just like children don't know need for school. It's up to the parents. And once it becomes a habit she won't miss wheat any more. The parents are just using this as an excuse to make their work easy.
you can council them that this anaemia is a result of the malabsorption she is suffering from. if she want to live healthy she has to stick to the limitations of food.
in my gp if I go for vit d test to any pt it's always very low .is this test of any significance as pts are not having any symptoms related to it and it's costly too or we can supplement vit d empirically .I tried it on symptomatic and non symptomatic pts.redults is always the same
I would respectfully disagree, gluten is causing ' leaky gut' which is responsible for her symptoms. Definitely she needs to go gluten free. Irrespective of biopsy result.
I think it will be very useful to check out articles by Dr David Perlmutter, and read his book, Grain Brain. It will bring a lot of clarity to this issue.
if TTG is positive n D2 biopay was normal tgen she is a case of Potential celiac disease....these patients have high chances of developing celiac disease in future....there isn't any recommendation to put these patients on GFD....
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Friends today I am discussing about a very common problem known as anemia which can lead to many problems. What Is Anemia? Anemia is a condition that develops when your blood lacks enough healthy red blood cells or hemoglobin. Hemoglobin is a main part of red blood cells and binds oxygen. If you have too few or abnormal red blood cells, or your hemoglobin is abnormal or low, the cells in your body will not get enough oxygen. Symptoms of anemia -- like fatigue -- occur because organs aren't getting what they need to function properly. Certain forms of anemia are hereditary and infants may be affected from the time of birth. Women in the childbearing years are particularly susceptible to iron-deficiency anemia because of the blood loss from menstruation and the increased blood supply demands during pregnancy. Older adults also may have a greater risk of developing anemia because of poor diet and other medical conditions. There are many types of anemia. All are very different in their causes and treatments. Iron-deficiency anemia, the most common type, is very treatable with diet changes and iron supplements. Some forms of anemia -- like the mild anemia that develops during pregnancy -- are even considered normal. However, some types of anemia may present lifelong health problems. What Causes Anemia? There are more than 400 types of anemia, which are divided into three groups: Anemia caused by blood loss Anemia caused by decreased or faulty red blood cell production Anemia caused by destruction of red blood cells Anemia Caused by Blood Loss Red blood cells can be lost through bleeding, which often can occur slowly over a long period of time, and can go undetected. This kind of chronic bleeding commonly results from the following: Gastrointestinal conditions such as ulcers, hemorrhoids, gastritis (inflammation of the stomach), and cancer Use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen, which can cause ulcers and gastritis Menstruation, especially if menstrual bleeding is excessive Anemia Caused by Decreased or Faulty Red Blood Cell Production With this type of anemia, the body may produce too few blood cells or the blood cells may not function correctly. In either case, anemia can result. Red blood cells may be faulty or decreased due to abnormal red blood cells or a lack of minerals and vitamins needed for red blood cells to work properly. Conditions associated with these causes of anemia include the following: Sickle cell anemia Iron-deficiency anemia Vitamin deficiency Bone marrow and stem cell problems Other health conditions Sickle cell anemia is an inherited disorder that, in the U.S. affects mainly African-Americans and Hispanic Americans. Red blood cells become crescent-shaped because of a genetic defect. They break down rapidly, so oxygen does not get to the body's organs, causing anemia. The crescent-shaped red blood cells can also get stuck in tiny blood vessels, causing pain. Iron-deficiency anemia occurs because of a lack of the mineral iron in the body. Bone marrow in the center of the bone needs iron to make hemoglobin, the part of the red blood cell that transports oxygen to the body's organs. Without adequate iron, the body cannot produce enough hemoglobin for red blood cells. The result is iron-deficiency anemia. This type of anemia can be caused by: An iron-poor diet, especially in infants, children, teens, vegans, and vegetarians The metabolic demands of pregnancy and breastfeeding that deplete a woman's iron stores Menstruation Frequent blood donation Endurance training Digestive conditions such as Crohn's disease or surgical removal of part of the stomach or small intestine Certain drugs, foods, and caffeinated drinks Vitamin-deficiency anemia may occur when vitamin B12 and folate are deficient. These two vitamins are needed to make red blood cells. Conditions leading to anemia caused by vitamin deficiency include: Megaloblastic anemia: Vitamin B12 or folate or both are deficient Pernicious anemia: Poor vitamin B12 absorption Dietary deficiency: Eating little or no meat may cause a lack of vitamin B12, while overcooking or eating too few vegetables may cause a folate deficiency. Other causes of vitamin deficiency: pregnancy, certain medications, alcohol abuse, intestinal diseases such as tropical sprue and celiac disease During early pregnancy, sufficient folic acid can help prevent the fetus from developing neural tube defects such as spina bifida. Bone marrow and stem cell problems may prevent the body from producing enough red blood cells. Some of the stem cells found in bone marrow develop into red blood cells. If stem cells are too few, defective, or replaced by other cells such as metastatic cancer cells, anemia may result. Anemia resulting from bone marrow or stem cell problems include: Aplastic anemia occurs when there's a marked reduction in the number of stem cells or absence of these cells. Aplastic anemia can be inherited, can occur without apparent cause, or can occur when the bone marrow is injured by medications, radiation, chemotherapy, or infection. Thalassemia occurs when the red cells can't mature and grow properly. 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