Verlaufsbeobachtung von Zöliakiepatienten im Kindes- und jungen Erwachsenenalter: latente oder transiente Zöliakie?
| Autor: | T Richter, Andrea Tannapfel, A. Limbach, D. M. Müller, T. Mothes, W. Hoepffner |
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| Rok vydání: | 2003 |
| Předmět: |
chemistry.chemical_classification
medicine.medical_specialty medicine.diagnostic_test biology business.industry nutritional and metabolic diseases Gluten intolerance Endomysium medicine.disease Gluten Gastroenterology Coeliac disease Lactase activity medicine.anatomical_structure Intestinal mucosa chemistry Internal medicine Pediatrics Perinatology and Child Health Biopsy Immunology medicine biology.protein business Gliadin |
| Zdroj: | Klinische Pädiatrie. 215:76-81 |
| ISSN: | 1439-3824 0300-8630 |
| Popis: | UNLABELLED Coeliac disease (CD) is known as a lifelong condition of gluten intolerance. In case of some patients, the time after which gluten exposition leads to damage of the small intestinal mucosa may be very long. In addition to the florid form of CD, there are also silent (atypical mono- and oligosymptomatic with typical damage of the small intestinal mucosa) and latent forms (often asymptomatic without clear mucosal changes, antibody titres often normal). Occasionally the development of gluten tolerance is postulated (transient CD). We investigated 47 subjects diagnosed in childhood definitely as CD patients. In the age of 16.3 +/- 4.8 years, the patients started a gluten containing diet. After 6 to 9 months of gluten containing diet a small intestinal biopsy was performed in all patients. Surprisingly we found 11 patients with normal small intestinal mucosa (group 1). The other 36 patients showed a flattened mucosa as expected (group 2). The further development of group 1 was followed. In 9 patients a further biopsy was performed after more than 2 (at maximum after 8.1) years of gluten containing diet. In all patients the morphology of the mucosa was normal. In 7 of 11 cases normal numbers of intraepithelial lymphocytes were counted. Only in two patients raised titres of gliadin and endomysium antibodies were found after 4.5 and 15 years of gluten containing diet. In the other 9 patients no increase in antibody titers was found up to 10.3 years. However, in group 1, mucosal lactase activity was decreased as was also the case for group 2. CONCLUSION A high number of adolescent coeliac patients does not respond or responds only minimally to reintroduction of gluten into the diet over a period longer than two years. These patients should regularly be further controlled serologically. |
| Databáze: | OpenAIRE |
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