Marzo 2016 - Volume XXXV - numero 3

Medico e Bambino


Focus

CELIACHIA 2016: DALLA TEORIA ALLA PRATICA

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CELIACHIA 2016: DALLA TEORIA ALLA PRATICA. Medico e Bambino 2016;35(3):159 https://www.medicoebambino.com/?id=1603_159.pdf

Focus

La diagnosi e il follow-up della celiachia

Tavolo Tecnico del Ministero della Salute

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Tavolo Tecnico del Ministero della Salute La diagnosi e il follow-up della celiachia. Medico e Bambino 2016;35(3):159 https://www.medicoebambino.com/?id=1603_159.pdf

Focus

Celiachia senza biopsia: dalle parole ai fatti

Elisa Benelli1, Valentina Carrato1, Stefano Martellossi2, Luca Ronfani2, Tarcisio Not1,2, Alessandro Ventura1,2

1Scuola di Specializzazione in Pediatria, Università di Trieste
2IRCCS Materno-Infantile “Burlo Garofolo”, Trieste

Indirizzo per corrispondenza: elisa.benelli@gmail.com

Diagnosis of coeliac disease without biopsy: from theory to practice

Key words: Coeliac disease, Diagnosis, Biopsy, IgA anti-transglutaminase

The aim of the present prospective study is to evaluate the clinical consequences of the last ESPGHAN and BSPGHAN guidelines for the diagnosis of Coeliac Disease (CD). All children (aged 0-18 years) diagnosed with CD from January 2011 to May 2014 at the IRCCS Burlo Garofolo of Trieste (Italy) were prospectively enrolled. Children diagnosed without a duodenal biopsy (Group 1) were matched for sex, age, and year of diagnosis to a sample of children diagnosed with a duodenal biopsy (Group 2). All patients were put on Gluten Free Diet (GFD) and followed-up for clinical condition, BMI, and laboratory tests (haemoglobin, serum anti-transglutaminase IgA antibodies) at six months and every year since diagnosis (median follow-up: 1.9 years). Adherence to GFD and quality of life of children were assessed through validated questionnaires. 51 out of 468 (11%) patients were diagnosed without a duodenal biopsy (Group 1; median age 2.1 years) and matched to 92 patients diagnosed with a biopsy (Group 2; median age 2.4 years). At the end of the follow-up the two groups resulted statistically comparable for clinical and nutritional status, serum anti-transglutaminase IgA antibodies titres, quality of life, adherence to GFD, and number of supplementary post-diagnosis medical consultations. The diagnosis of CD can be safely performed without a duodenal biopsy at least in 11% of cases. At least during a medium-term follow-up, this approach has no negative consequence on clinical remission, adherence to diet, and quality of children’s lives.

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E. Benelli, V. Carrato, S. Martelossi, L. Ronfani, T. Not, A. Ventura Celiachia senza biopsia: dalle parole ai fatti. Medico e Bambino 2016;35(3):159 https://www.medicoebambino.com/?id=1603_159.pdf

Focus

I depositi intestinali degli anticorpi anti-transglutaminasi

Luigina De Leo1, Ilma Korponai-Szabo2, Markku Mäki3, Grazia Di Leo1, Stefano Martelossi1, Vincenzo Villanacci4, Tarcisio Not1,5, Alessandro Ventura1,5

1Clinica Pediatrica, IRCCS Materno-Infantile “Burlo Garofolo”, Trieste
2Department of Paediatrics, University of Debrecen Medical School, Hungary
3Tampere Centre for Child Health Research, School of Medicine, University of Tampere and Tampere University Hospital, Tampere, Finland
4Anatomia Patologica, Spedali Civili, Brescia
5Università di Trieste

Indirizzo per corrispondenza: deleo.luigina@libero.it

Intestinal deposits of anti-transglutaminase antibodies

Key words: Coeliac disease, Intestinal deposits of IgA anti-transglutaminase

The serum anti-transglutaminase antibodies are the immunological markers for coeliac disease diagnosis. These autoantibodies are synthesized by B-lymphocytes at the intestinal level and their presence in the form of intestinal deposits is a constant feature in the different clinical entities in which coeliac disease is classified: classical, silent, and potential. These intestinal autoantibodies are the first gluten dependent inflammatory markers and they appear before both the intestinal damage and the serum anti-transglutaminase antibodies. The anti-transglutaminase deposits should be looked for to confirm or exclude the diagnosis of coeliac disease when the clinical and immunological features are incomplete or in asymptomatic at risk patients.

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L. De Leo, I. Korponai-Szabo, M. Mäki, G. Di Leo, S. Martelossi, V. Villanacci, T. Not, A. Ventura I depositi intestinali degli anticorpi anti-transglutaminasi. Medico e Bambino 2016;35(3):159 https://www.medicoebambino.com/?id=1603_159.pdf


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