Can Serologic Markers Prove Dietary
Mistakes in Patients with Coeliac Disease?
Ilavská A.1,2, Beňo I.2, Gomolčák P.3, Paulovičová E.4
1Interné oddelenie Železničnej nemocnice s poliklinikou, Bratislava, Slovenská republika, prednosta prim. MUDr. M. Brix, CSc. 2Klinické oddelenie Ústavu preventívnej a klinickej medicíny, Bratislava, Slovenská republika, riaditeľ doc. MUDr. Š. Nyulassy, DrSc. 3Ústav patológie FNsP akademika L. Dérera, Bratislava, Slovenská republika, prednosta prim. doc. MUDr. D. Daniš, CSc. 4Oddelenie klinickej imunológie a alergológie Národného ústavu tuberkulózy a respiračných chorôb, Bratislava, Slovenská republika, prednosta prim. MUDr. M. Hrubiško, Ph.D. |
|
Summary:
Coeliac disease is a disease of small intestine requiring life-long strict gluten free diet to avoid
acute and chronic complications. To reach maximum adherence to the diet is in some of coeliac
patients, especially adults, difficult because it requires distinct changes in eating habits. To diagnose
coeliac disease tests of antigliadin and anti-endomysial antibodies in serum are used.
Authors monitored levels of antibodies in 32 adults 3, 6, and 12 month after histology validation of
coeliac disease and after recommendation of a gluten free diet. The results were compared with
data from nutritional history. Maximum adherence to the diet indicated 24 patients (75 %), occasional
consummation of gluten indicated 6 patients (19 %) and more frequent breaking a diet indicated
2 patients (6 %). In a group which adhered to the diet the most rapid was a decline in levels
of anti-endomysial antibodies, less rapid was a decline in levels of IgA-class antigliadin antibodies,
and the least rapid was a decline in levels of IgG-class antigliadin antibodies. In the group
with occasional intake of gluten was the decline slower and in the group with frequent dietary
mistakes levels of antibodies have not declined at all. Adherence to the diet positively correlated
with level of accomplished education of patients. Monitoring of titter kinetics proved to be a good
indicator of discipline and cooperation of patients during treatment with gluten free diet.
Key words:
Coeliac disease - Biopsy of small intestine - Antigliadin antibodies - Anti-endomysial
antibodies - Gluten free diet - Dietary compliance
|