Gluten enteropathy
Authors:
Z. Mináriková; Z. Bartošová; K. Letková; S. Oravec
Authors‘ workplace:
Prednosta: doc. MUDr. Ľudovít Gašpar, CSc.
; II. interná klinika LFUK a UNB Bratislava, Slovensko
Published in:
Prakt. Lék. 2012; 92(2): 77-84
Category:
Reviews
Overview
Celiac disease is a chronic disease characterized by an immune response to gluten in genetically predisposed patients. Its severe complications may not only increase morbidity and shorten the life of the patient, but also substantially reduce patient quality of life. Through early diagnosis and careful dietary measures it is possible to achieve a resolution of clinical symptoms in a substantial proportion of patients and the incidence of serious complications of the disease can be reduced.
Although the pathogenesis and treatment of the disease is known, and a methodical approach to the diagnosis of celiac disease has been developed and accepted by several professional societies, there are still a large number of patients that escape diagnosis and not only in childhood but mostly in adulthood. It is necessary to bear in mind the wide range of clinical manifestations of celiac disease, which is the result of a complex interaction of various environmental, genetic and immune factors.
Although examination of circulating auto-antibodies in the serum is within the diagnostic algorithm prior to biopsy, especially in the diagnosis of atypical forms, its specificity and sensitivity is not always adequate. It is obvious that the application of targeted screening can help discover new, especially atypical forms of celiac disease, but some will nevertheless remain undiagnosed.
Key words:
celiac disease, gluten, malabsorption, tissue transglutaminase, gluten-free diet, atypical presentations of celiac disease.
Sources
1. Ambrosetto, G., Antonini, L., Tassinari, C.A. Occipital lobe seizures related to clinically asymptomatic celiac disease in adulthood. Epilepsia 1992, 33, p. 476-481.
2. Bardella, M.T., Minoli, G., Radaelli, F. et al. Re-evaluation of duodenal endoscopic markers in the diagnosis of celiac disease. Gastrointest. Endosc. 2000, 51, p. 714-716.
3. Bruce, S.E., Bjarnason, I., Peters, T.J. Jejunal transglutaminase - demonstration of activity, enzyme-kinetics, substrate-specificity and levels in patients with celiac-disease. Clin. Sci. 1984, 66, p. 64.
4. Card, T.R, West, J., Holmes G.K. Risk of malignancy in diagnosed coeliac disease: a 24-year prospective, population-based, cohort study. Aliment. Pharmacol. Ther. 2004, 20, p. 769-775.
5. Case records of the Massachusetts General Hospital (Case 5-2001). N. Engl. J. Med. 2001, 344, p. 510-517.
6. Rakover, Y., Hager, H., Nussinson, E., Luboshitzky, R. Celiac disease as a cause of transient hypocalcemia and hypovitaminosis D in a 13 year-old girl. J. Pediatr. Endocrinol. Metab. 1994, 7, p.53-56.
7. Daum, S., Hummel, M., Weiss, D. et al. Refractory sprue syndrome with clonal intraepithelial lymphocytes evolving into overt enteropathy-type intestinal T-cell lymphoma. Digestion 2000, 62, p. 60-65.
8. Di Sabatino, A., Ciccocioppo, R., Daló, S. et al. Intraepithelial and lamina propria lymphocytes show distinct patterns of apoptosis whereas both populations are active in Fas based cytotoxicity in coeliac disease. Gut 2001, 49, p. 380-386.
9. Dítě, P., Lukáš, M., Lata, J. a kol. Celiakie. In Češka R., Dítě P., Štulc T., Tesař V. a kol. Interna, Praha: Triton 2010, s. 391-394. ISBN 978-80-7387-423-0.
10. Donald, A.A. Celiac disease: a progress report. Mod. Pathol. 2003,16, p. 342-346.
11. Donaldson, M.R., Book, L.S., Leiferman, K.M. et al. Strongly positive tissue transglutaminase antibodies are associated with Marsh 3 histopathology in adult and pediatric celiacdisease. J. Clin. Gastroenterol. 2008, 42, p. 256-260.
12. Fassano, A., Catassi, C. Current approaches to diagnosis and treatment of celiac disease: an evolving spectrum. Gastroenterol. 2001, 120, p. 636-651.
13. Greco, L., Romino, R., Coto, I. et al. The first large populationbased twin study of celiac disease. Gut 2002, 50, p. 624-628.
14. Green. P.H.R., Bana. J. Coeliac disease, Lancet 2003, 362, p. 383-391.
15. Godkin. A., Jewell. D. The pathogenesis of celiac disease. Gastroenterol.1998, 115, p. 206-210.
16. Halpert, A.D. Importance of early diagnosis in patients with irritable bowel syndrome. Postgraduate Medicine 2010, 122, p. 102-110.
17. Harper, J.W., Holleran, S.F., Ramakrishnan, R. et al. Anemia in celiac disease is multifactorial in etiology. Am. J. Hematol. 2007, 82, p. 996-1000.
18. Janutuinen, E.K., Pikkarainen, P.H., Kemppainen, T.A. et al. A comparison of diets with and without oats in adults with celiac disease. N. Engl. J. Med. 1995, 333, p. 1033-1037.
19. Jirásek, V. Celiakální sprue, gluténová enteropatie. In Klener P. a kol. Vnitřní lékařství. Praha: Galén a Karolinum 2006, 3. vyd., s. 591-592. ISBN 80-7262-430-X (Galén), ISBN 80-246-1252-6 (Karolinum).
20. Lísová, S., Ehrmann, J., Kolek A. a kol. Imunohistochemická studie mechanismů apoptózy a proliferace ve sliznici tenkého střeva u celiakální sprue. Česk-Slov Patol. 2005, 41, s. 85-93.
21. Ludvigsson, J.F., Montgomery, S.M., Ekbom, A. Celiac disease and risk of adverse fetal outcome: a population-based cohort study. Gastroenterol. 2005,129, p.454-463.
22. Maki, M. Tissue transglutaminase as the autoantigen of coeliac disease. Gut 1997, 41, p. 565-566.
23. Maki, M., Collin, P. Coeliac disease. Lancet 1997, 349, p. 1755-1759.
24. Makovický, P., Rimárová, K. Význam a možnosti skríningu v diagnostike celiakie. Vnitř. Lék. 2011, 57, s. 183-187.
25. O’Malley, D.P., Gulley, M.L., Banks P.M. Enteropathy-type T-cell lymphoma: its relationship to refractory celiac disease. Pathol. Case Rev. 2002, 7, p. 110-116.
26. Pekárková, B., Pekárek, B., Kabátová, J. Štandardný diagnostický a terapeutický postup: 46. Metodický list racionálnej farmakoterapie: Racionálna diagnostika a liečba celiakie: Metodický list Ústrednej komisie racionálnej farmakoterapie a liekovej politiky MZ SR, Herba 2009, r. 13, č. 1-2.
27. Prince, H.E. Evaluation of the INOVA diagnostics enzyme-linked immunosorbent assay kits for measuring serum immunoglobulin G (IgG) and IgA to deamined gliadin peptides. Clin. Vaccine Immunol. 2006, 13, p. 150-151.
28. Riches, Ph.L., McRorie, E., Fraser, W.D. et al. Osteoporosis associated with neutralizing autoantibodies against osteoprotegerin. N. Engl. J. Med. 2009, 361, 15, p. 1459-1465.
29. Rostami, K., Kerckhaert, J., Tiemessen, R. et al. Sensitivity of antiendomysium and antigliadin antibodies in untreated celiac disease: Disappointing in clinical practice. Amer. J. Gastroenterol. 1999, 94, p. 888-893.
30. Rostami, K., Kerckhaert, J., Tiemessen R. et al. The realtionship between anti-endomysium antibodies and villous atrophy in coeliac disease using both monkey and human substrate. Eur. J. Gastroenterol. Hepatol. 1999, 11, p. 439-442.
31. Rostami, K., Steegers, E.A.P., Wong, W.Y. et al. Coeliac disease and reproductive disorders: a neglected association. Eur. J. Obstet. Gynecol. Reprod. Biol. 2001, 96, p. 146-149.
32. Sanders, D.S., Carter, M.J., Hurlstone D.P. et al. Association of adult coeliac disease with irritable bowel syndrome: a casecontrol study in patients fulfilling ROME II criteria referred to secondary care. Lancet 2001, 358, p. 1504-1508.
33. Shah, V.H., Rotterdam, H., Kolter, D.P. et al. All that scallops is not celiac disease. Gastrointest. Endosc. 2000, 51, p. 717-720.
34. Smyth, D.J., Plagnol, V., Walker, N.M. et al. Shared and distinct genetic variants in type 1 diabetes and celiac disease. N. Engl. J. Med. 2008, 359, p. 2767-2777.
35. Sugai, E., Moreno, M.L., Hwang, H.J. et al. Celiac disease serology in patients with different pretest probabilities: is biopsy avoidable? World J. Gastroenterol. 2010, 16, p. 3144–3152.
36. Šašinka, M. Poruchy resorbcie. Celiakia. In Šašinka M., Šagát T., et al. Pediatria. Košice: Satus 1998, s. 386-388. ISBN 80-967963-0-5, 9.
37. Tata, L.J., Card, T.R., Logan, R.F. et al. Fertility and pregnancy-related events in women with celiac disease: a population-based cohort study. Gastroenterol. 2005, 128, p. 849-855.
38. Trier, J.S. Diagnosis of celiac sprue. Gastroenterol. 1998, 115, p.211-216.
39. Tursi, A., Brandimarte, G., Giorgetti, G. et al. Low prevalence of antigliadin and anti-endomysium antibodies in subclinical/ silent celiac disease. Am. J. Gastroenterol. 2001, 96, p. 1507-1510.
40. van Hee, D.A., West, J. Recent advances in clinical practice: Recent advances in coeliac disease. Gut 2006, 55, p. 1037-1046.
41. Vermeersch, P., Richter, T., Hauer A.C. et al. Use of likelihood ratios improves clinical interpretation of IgG and IgA anti-DGP antibody testing for celiac disease in adults and children. Clin. Biochem. 2010, 411, p. 13-17.
42. Wahnschaffe, U., Ullrich, R., Riechen, E.O., Schulzke J.D. Celiac disease-like abnormalities in a subgroup of patients with irritable bowel syndrome. Gastroenterol. 2001, 121, p. 1329-1338.
43. Walburga, D., Ehnis, T., Bauer M. et al. Identification of tissue transglutaminase as the autoantigen of celiac disease. Nat. Med. 1997, 3, p. 797-801.
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