Léčba celiakie, rozpor mezi subjektivními údaji a výsledky vyšetření protilátek

Treatment of Coeliac Disease, Discrepancy between Subjective Data and Results of AntibodyExamination

Objective:
Checking adherence to gluten-free diet by affected children and adolescents with coeliac disease.Patients and methods: In 145 patients with coeliac disease and villous atrophy of the jejunal mucosa, treatedfor at least 6 months, the dietary regime was evaluated as strictly gluten-free (no gluten-containing meals),semi-strict (1 - 3 meals with gluten) and liberal (4 and more gluten containing meals per month). Concurrently theresults of examination of endomysial antibodies (EMA) were evaluated as well as antibodies against tissuetransglutaminase (tTGA). In none of the patients IgA deficiency in serum was found.Results: Adherence to the gluten-free regime was reported by 118 (81.3%), a semi-strict regime by 10 (6.8%)and the gluten-free diet was not respected by 17 children (11.7%). Among the 118 patients adhering to thegluten-free regime slight EMA positivity was recorded 21x (17.7%) andEMA positivity 22x (18.6%). The presenceof tTGA was found 35x (29.6%).Conclusion: 81.3% patients report adherence to a gluten-free diet. In one third of them the presence of tissueantibodies was found. This disproportion can be explained by not admitted or unaware gluten consumption. Itspresence was recently repeatedly proved by analysis of gluten-free foods by the Czech Agricultural and FoodInspection and Balada Co.

Key words:
coeliac disease, gluten-free diet, endomysial antibodies, antibodies against tissue transglutaminase