Histopathological Diagnosis of Celiac Disease in Adults with Functional Dyspeptic Syndrome
Makovický P.1, Makovický P.1,2, Greguš M.3, Klimik M.4, Zimmermann M.5
1Ústav patológie, 4Oddelenie klinickej imunológie, 5Ústav klinickej mikrobiológie FN, Nitra 2Slovenská poľnohospodárska univerzita, Nitra 3Gastroenterologické oddelenie, Nitra |
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Summary:
Celiac disease is associated with permanent intolerance to gluten, which is found in some cereals. The symptoms of the disease are often
nonconspicuous and the course of the disease is atypical. With the introduction of serological markers as a sensitive method of testing new
cases of the disease were identified. Despite of the increased screening intensity among children and adults celiac disease in our region is
still underdiagnosed. The article deals with the diagnostics of celiac disease in adults with functional dyspeptic syndrome. It is based on
the laboratory and pathological correlation of 25 patients. Our aim was to identify the group at risk with functional dyspeptic syndrome and
celiac disease. This disease can show symptoms from the onset all the way to relapse. Each person was examined by a gastroenterologist
while hospitalized in the relevant department. In addition to the routine serological testing, blood samples were taken and sent for
antiendomyzial antibody testing for positive reaction verification. A subsequent gastrointestinal examination was done and samples taken
from the duodenum were sent for histology. Light microscopy analysis showed mucous damage typical for celiac disease, which is
expressed with the levels of the Marsh histological grading. In closing, we recommend a three-step approach to goal-oriented screening of
celiac disease. Determination of autoantibody against tissue transglutaminase, if positive, then biopsy from the aboral duodenum, and
consequently follow-up by testing for antiendomyzial antibody.
Key words:
autoantibody – gluten-free diet – celiac disease – enterobiopsy – malabsorption syndrome
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