Celiac Disease in Children
- Autores: Isabel Polanco Allué
- Localización: Celiac Disease and Non-Celiac Gluten Sensitvity / coord. por Amado Salvador Peña; Luis Rodrigo (ed. lit.), 2014, ISBN 978-84-942118-2-9, págs. 221-234
- Idioma: inglés
- Enlaces
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Resumen
Celiac Disease (CD) is an immune-mediated systemic disorder caused by gluten and relatedprolamins in genetcally susceptble individuals, characterized by the presence of a variablecombinaton of gluten-dependent clinical manifestatons, CD-specifc antbodies, HLA-DQ2 orHLA-DQ8 haplotypes and enteropathy. CD-specifc antbodies comprise autoantbodies againstTGt2, including endomysial antbodies (EMA) and antbodies against deamidated forms of gliadinpeptdes (DGP). To diagnose children and adolescents without intestnal biopsy, the following conditons areimperatve: signs or symptoms suggestve of CD, high ant-TG2 levels (>10 tmes UNL), verifed byEMA and positve HLA-DQ2 and/or DQ8. Only then the intestnal biopsy can be avoided, the CDdiagnosis made and the child started on a gluten-free diet (GFD). In childhood and adolescence, intestnal biopsy can be omited in symptomatc subjects withhigh ant-TG2-IgA levels (>10 tmes normal values), verifed by EMA and positve HLA-DQ2 and/orHLA-DQ8. In these cases, a GFD can be started. In all other cases, intestnal biopsies should beperform frst before startng a GFD to avoid misdiagnosis.
