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Aretin'ny seliaka

Avy amin'i Wikipedia
Coeliac disease
Anarana hafa: Celiac sprue, nontropical sprue, endemic sprue, gluten enteropathy
Biopsy of small bowel showing coeliac disease manifested by blunting of villi, crypt hypertrophy, and lymphocyte infiltration of crypts
Anarana iombonana
Manam-pahaizana manokana momba nyGastroenterology, internal medicine
Soritr'aretinaNone or non-specific, abdominal distention, diarrhoea, constipation, malabsorption, weight loss, dermatitis herpetiformis[1][2]
Fanombohana mahazatraAny age[1][3]
FaharetanaLifelong[4]
AntonyReaction to gluten[5]
Antony mety hampidi-dozaGenetic predisposition[6]
DiagnostikaFamily history, blood antibody tests, intestinal biopsies, genetic testing, response to gluten withdrawal[6][7]
Diagnostika samihafaInflammatory bowel disease, intestinal parasites, irritable bowel syndrome, cystic fibrosis[8]
FitsaboanaGluten-free diet[9]
Hatetika~1 in 135[10]

Ny aretin'ny seliaka na ny aretin'ny seliaka dia aretina maharitra ateraky ny hery fiarovana izay misy fiantraikany voalohany indrindra amin'ny tsinay kely.[6] Anisan'ny soritr'aretina mahazatra ny olana amin'ny fandevonan-kanina toy ny aretim-pivalanana mitaiza, fivontosan'ny kibo, tsy fahatomombanan'ny fidiran'ny sakafo, tsy fahazotoan-komana, ary ny tsy fahampian'ny fitomboana ara-dalàna eo amin'ny ankizy.[1] Matetika izany dia manomboka eo anelanelan'ny enim-bolana sy roa taona.[1] Ireo soritr'aretina tsy mahazatra dia mahazatra kokoa, indrindra amin'ny olona mihoatra ny roa taona.[3][11][12] Mety hisy soritr'aretina malemy na tsy misy mihitsy eo amin'ny tsinay, soritr'aretina maro samihafa mahakasika ny faritra rehetra amin'ny vatana na tsy misy soritr'aretina miharihary.[1] Ny aretin'ny seliaka dia voalaza voalohany tamin'ny fahazazana; [4][3] na izany aza, mety hitranga amin'ny sokajin-taona rehetra izany.[1][3] Mifandray amin'ny aretina autoimmune hafa izy io, toy ny diabeta mellitus karazany 1 sy ny tiroidita, ankoatra ny hafa.[4]

Ny aretin'ny seliaka dia vokatry ny fihetsika amin'ny gluten, vondron'ny proteinina isan-karazany hita ao amin'ny varimbazaha sy amin'ny voamaina hafa toy ny orza sy ny rye.[5][13][14] Matetika azo leferina ny oats amin'ny habetsahana antonony, izay tsy misy loto avy amin'ny voamaina hafa misy gluten.[13][15] Mety hiankina amin'ny karazana vary orza ny fisian'ny olana.[13][16] Mitranga amin'ny olona manana fototarazo mora voan'izany izany.[6] Rehefa tratran'ny gluten, ny valin-kafatra tsy ara-dalàna amin'ny hery fiarovana dia mety hitarika amin'ny famokarana autoantibodies samihafa izay mety hisy fiantraikany amin'ny taova samihafa.[17] Ao amin'ny tsinay kely, miteraka fivontosana izany ary mety hiteraka fihenan'ny villi mandrakotra ny tsinay kely ( atrophy villous ).[6][7] Misy fiantraikany amin'ny fidiran'ny otrikaina izany, izay matetika mitarika ho amin'ny tsy fahampian-dra.[6][14]

Matetika ny aretina dia atao amin'ny alalan'ny fitambaran'ny fitiliana antibody amin'ny ra sy ny biopsie amin'ny tsinay, izay ampian'ny fitiliana fototarazo manokana.[6] Tsy mora foana ny mamantatra ny aretina.[18] Matetika, ratsy ny autoantibodies ao amin'ny ra,[19][20] ary olona maro no manana fiovana kely amin'ny tsinay miaraka amin'ny villi ara-dalàna.[21] Mety hisy soritr'aretina mafy ny olona ary mety hodinihina mandritra ny taona maro izy ireo alohan'ny hahitana ny aretina.[22][23] Mihamaro hatrany ny olona tsy manana soritr'aretina voamarina, vokatry ny fitiliana.[24] Na izany aza, tsy ampy ny porofo momba ny vokatry ny fitiliana mba hamaritana ny maha-ilaina azy.[25] Na dia vokatry ny tsy fahazakana maharitra ny proteinina gluten aza ity aretina ity,[6] dia miavaka amin'ny alèjy amin'ny varimbazaha izy io, izay tsy fahita firy.[26]

Ny fitsaboana mahomby fantatra ihany dia ny fihinanana sakafo tsy misy gluten mandritra ny androm-piainana, izay mitarika amin'ny famerenana amin'ny laoniny ny rindrin'ny tsinay, manatsara ny soritr'aretina ary mampihena ny mety hisian'ny fahasarotana amin'ny ankamaroan'ny olona.[9] Raha tsy voatsabo dia mety hiteraka homamiadana toy ny lymphoma amin'ny tsinay ary mety hampitombo kely ny mety ho fahafatesana aloha loatra.[27] Miovaova arakaraka ny faritra eto amin'izao tontolo izao ny tahan'ny aretina, manomboka amin'ny 1 amin'ny 300 ka hatramin'ny 1 amin'ny 40, miaraka amin'ny salan'isa eo anelanelan'ny 1 amin'ny 100 sy 1 amin'ny olona 170.[10] Tombanana ho 80%-n'ny tranga no mbola tsy voamarina, matetika noho ny tsy fahampian'ny na tsy fisian'ny olana amin'ny fandevonan-kanina sy ny tsy fahampian'ny fahalalana ny soritr'aretina sy ny fepetra takiana amin'ny diagnostika.[28][22][29] Somary mahazatra kokoa amin'ny vehivavy ny aretin'ny seliaka raha oharina amin'ny lehilahy.[30]

References

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  1. 1 2 3 4 5 6 "Clinical presentation of celiac disease in the pediatric population". Gastroenterology 128 (4 Suppl 1): S68–73. April 2005. doi:10.1053/j.gastro.2005.02.015. PMID 15825129.
  2. ↑ "Symptoms & Causes of Celiac Disease | NIDDK". National Institute of Diabetes and Digestive and Kidney Diseases. June 2016. Archived from the original on 24 April 2017. Retrieved 24 April 2017.
  3. 1 2 3 4 "European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease". J Pediatr Gastroenterol Nutr 54 (1): 136–60. January 2012. doi:10.1097/MPG.0b013e31821a23d0. PMID 22197856. http://www.espghan.org/fileadmin/user_upload/guidelines_pdf/Guidelines_2404/European_Society_for_Pediatric_Gastroenterology_.28__1_.pdf. Retrieved 19 March 2016. "Since 1990, the understanding of the pathological processes of CD has increased enormously, leading to a change in the clinical paradigm of CD from a chronic, gluten-dependent enteropathy of childhood to a systemic disease with chronic immune features affecting different organ systems. (...) atypical symptoms may be considerably more common than classic symptoms"
  4. 1 2 3 "The Spectrum of Differences between Childhood and Adulthood Celiac Disease". Nutrients 7 (10): 8733–51. 22 October 2015. doi:10.3390/nu7105426. PMC 4632446. PMID 26506381. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4632446. "Several additional studies in extensive series of coeliac patients have clearly shown that TG2A sensitivity varies depending on the severity of duodenal damage, and reaches almost 100% in the presence of complete villous atrophy (more common in children under three years), 70% for subtotal atrophy, and up to 30% when only an increase in IELs is present. (IELs: intraepithelial lymphocytes)"
  5. 1 2 "Clinical and diagnostic aspects of gluten related disorders". World Journal of Clinical Cases 3 (3): 275–84. March 2015. doi:10.12998/wjcc.v3.i3.275. PMC 4360499. PMID 25789300. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4360499.
  6. 1 2 3 4 5 6 7 8 "Celiac Disease". NIDDKD. June 2015. Archived from the original on 13 March 2016. Retrieved 17 March 2016.
  7. 1 2 "Age-related differences in celiac disease: Specific characteristics of adult presentation". World Journal of Gastrointestinal Pharmacology and Therapeutics 6 (4): 207–12. November 2015. doi:10.4292/wjgpt.v6.i4.207. PMC 4635160. PMID 26558154. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4635160. "In addition, the presence of intraepithelial lymphocytosis and/or villous atrophy and crypt hyperplasia of small-bowel mucosa, and clinical remission after withdrawal of gluten from the diet, are also used for diagnosis antitransglutaminase antibody (tTGA) titers and the degree of histological lesions inversely correlate with age. Thus, as the age of diagnosis increases antibody titers decrease and histological damage is less marked. It is common to find adults without villous atrophy showing only an inflammatory pattern in duodenal mucosa biopsies: Lymphocytic enteritis (Marsh I) or added crypt hyperplasia (Marsh II)"
  8. ↑ (2010) Ferri's differential diagnosis : a practical guide to the differential diagnosis of symptoms, signs, and clinical disorders, 2nd, Philadelphia, PA: Elsevier/Mosby.
  9. 1 2 "Practical insights into gluten-free diets". Nature Reviews. Gastroenterology & Hepatology 12 (10): 580–91. October 2015. doi:10.1038/nrgastro.2015.156. PMID 26392070. "A lack of symptoms and/or negative serological markers are not reliable indicators of mucosal response to the diet. Furthermore, up to 30% of patients continue to have gastrointestinal symptoms despite a strict GFD.122,124 If adherence is questioned, a structured interview by a qualified dietitian can help to identify both intentional and inadvertent sources of gluten."
  10. 1 2 "Clinical practice. Celiac disease". The New England Journal of Medicine 367 (25): 2419–26. December 2012. doi:10.1056/NEJMcp1113994. PMID 23252527.
  11. ↑ Newnham, Evan D (2017). "Coeliac disease in the 21st century: Paradigm shifts in the modern age". Journal of Gastroenterology and Hepatology 32: 82–85. doi:10.1111/jgh.13704. PMID 28244672. "Presentation of CD with malabsorptive symptoms or malnutrition is now the exception rather than the rule."
  12. ↑ "Diagnosis and classification of celiac disease and gluten sensitivity". Autoimmun Rev 13 (4–5): 472–6. 2014. doi:10.1016/j.autrev.2014.01.043. PMID 24440147.
  13. 1 2 3 "Gluten-free diet in children: an approach to a nutritionally adequate and balanced diet". Nutrients 5 (11): 4553–65. November 2013. doi:10.3390/nu5114553. PMC 3847748. PMID 24253052. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3847748.
  14. 1 2 "Coeliac disease". Lancet 373 (9673): 1480–93. April 2009. doi:10.1016/S0140-6736(09)60254-3. PMID 19394538.
  15. ↑ "Safety of Adding Oats to a Gluten-Free Diet for Patients With Celiac Disease: Systematic Review and Meta-analysis of Clinical and Observational Studies". Gastroenterology 153 (2): 395–409.e3. August 2017. doi:10.1053/j.gastro.2017.04.009. PMID 28431885. http://eprints.whiterose.ac.uk/115341/1/FordSafety%20of%20Adding%20Oats.pdf. Retrieved 2020-08-06.
  16. ↑ "Role of oats in celiac disease". World Journal of Gastroenterology 21 (41): 11825–31. November 2015. doi:10.3748/wjg.v21.i41.11825. PMC 4631980. PMID 26557006. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4631980. "It is necessary to consider that oats include many varieties, containing various amino acid sequences and showing different immunoreactivities associated with toxic prolamins. As a result, several studies have shown that the immunogenicity of oats varies depending on the cultivar consumed. Thus, it is essential to thoroughly study the variety of oats used in a food ingredient before including it in a gluten-free diet."
  17. ↑ "Coeliac disease and autoimmune disease-genetic overlap and screening". Nature Reviews. Gastroenterology & Hepatology 12 (9): 507–15. September 2015. doi:10.1038/nrgastro.2015.136. PMID 26303674. "The abnormal immunological response elicited by gluten-derived proteins can lead to the production of several different autoantibodies, which affect different systems."
  18. ↑ "Diagnostic challenges in celiac disease and the role of the tissue transglutaminase-neo-epitope". Clin Rev Allergy Immunol 38 (2–3): 298–301. April 2010. doi:10.1007/s12016-009-8160-z. PMID 19629760.
  19. ↑ "Systematic review: the use of serology to exclude or diagnose coeliac disease (a comparison of the endomysial and tissue transglutaminase antibody tests)". Alimentary Pharmacology & Therapeutics 24 (1): 47–54. July 2006. doi:10.1111/j.1365-2036.2006.02967.x. PMID 16803602.
  20. ↑ "American Gastroenterological Association (AGA) Institute technical review on the diagnosis and management of celiac disease". Gastroenterology 131 (6): 1981–2002. December 2006. doi:10.1053/j.gastro.2006.10.004. PMID 17087937. http://www.gastrojournal.org/article/S0016-5085%2806%2902227-X/fulltext. Retrieved 2020-08-06.
  21. ↑ "Systematic review: noncoeliac gluten sensitivity". Alimentary Pharmacology & Therapeutics 41 (9): 807–20. May 2015. doi:10.1111/apt.13155. PMID 25753138. "Furthermore, seronegativity is more common in coeliac disease patients without villous atrophy (Marsh 1-2 lesions), but these ‘minor’ forms of coeliac disease may have similar clinical manifestations to those with villous atrophy and may show similar clinical–histological remission with reversal of haematological or biochemical disturbances on a gluten-free diet (GFD)."
  22. 1 2 "Diagnosis and Treatment Patterns in Celiac Disease". Dig Dis Sci 64 (8): 2095–2106. 1 March 2019. doi:10.1007/s10620-019-05528-3. PMID 30820708.
  23. ↑ "Support for patients with celiac disease: A literature review". United European Gastroenterology Journal 3 (2): 146–59. April 2015. doi:10.1177/2050640614562599. PMC 4406900. PMID 25922674. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4406900.
  24. ↑ "Recent advances in coeliac disease". Gut 55 (7): 1037–46. July 2006. doi:10.1136/gut.2005.075119. PMC 1856316. PMID 16766754. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1856316.
  25. ↑ "Screening for Celiac Disease: US Preventive Services Task Force Recommendation Statement". JAMA 317 (12): 1252–1257. March 2017. doi:10.1001/jama.2017.1462. PMID 28350936.
  26. ↑ Burkhardt, J. G.; Chapa-Rodriguez, A.; Bahna, S. L. (July 2018). "Gluten sensitivities and the allergist: Threshing the grain from the husks". Allergy 73 (7): 1359–1368. doi:10.1111/all.13354. PMID 29131356.
  27. ↑ "Celiac disease and non-celiac gluten sensitivity". BMJ 351: h4347. October 2015. doi:10.1136/bmj.h4347. PMC 4596973. PMID 26438584. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4596973. "Celiac disease occurs in about 1% of the population worldwide, although most people with the condition are undiagnosed. It can cause a wide variety of symptoms, both intestinal and extra-intestinal because it is a systemic autoimmune disease that is triggered by dietary gluten. Patients with coeliac disease are at increased risk of cancer, including a twofold to fourfold increased risk of non-Hodgkin’s lymphoma and a more than 30-fold increased risk of small intestinal adenocarcinoma, and they have a 1.4-fold increased risk of death."
  28. ↑ "Celiac disease". World Gastroenterology Organisation Global Guidelines. July 2016. Archived from the original on 17 March 2017. Retrieved 23 April 2017.
  29. ↑ "Celiac disease from a global perspective". Best Practice & Research. Clinical Gastroenterology 29 (3): 365–79. June 2015. doi:10.1016/j.bpg.2015.05.004. PMID 26060103.
  30. ↑ "Review article: safe amounts of gluten for patients with wheat allergy or coeliac disease". Alimentary Pharmacology & Therapeutics 23 (5): 559–75. March 2006. doi:10.1111/j.1365-2036.2006.02768.x. PMID 16480395.
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