Celiac Disease in Children

Isabel Polanco

Resumen


Celiac Disease (CD) is an immune-mediated systemic disorder caused by gluten and related prolamins in genetically susceptible individuals, characterized by the presence of a variable combination of gluten-dependent clinical manifestations, CD-specific antibodies, HLA-DQ2 or HLA-DQ8 haplotypes and enteropathy. CD-specific antibodies comprise autoantibodies against TGt2, including endomysial antibodies (EMA) and antibodies against deamidated forms of gliadin peptides (DGP). To diagnose children and adolescents without intestinal biopsy, the following conditions are imperative: signs or symptoms suggestive of CD, high anti-TG2 levels (>10 times UNL), verified by EMA and positive HLA-DQ2 and/or DQ8. Only then the intestinal biopsy can be avoided, the CD diagnosis made and the child started on a gluten-free diet (GFD). In childhood and adolescence, intestinal biopsy can be omitted in symptomatic subjects with high anti-TG2-IgA levels (>10 times normal values), verified by EMA and positive HLA-DQ2 and/or HLA-DQ8. In these cases, a GFD can be started. In all other cases, intestinal biopsies should be perform first before starting a GFD to avoid misdiagnosis.

Palabras clave


celiac, children

Texto completo: PDF

Refbacks

  • No hay Refbacks actualmente.



OmniaScience, 2011-2017 - www.omniascience.com