CRIBADO DE LA ENFERMEDAD CELÍACA EN POBLACIÓN PEDIÁTRICA
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2019-09-19
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Jaén: Universidad de Jaén
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[ES]La enfermedad celíaca (EC) es un desorden sistémico mediado por el sistema inmunitario, en individuos genéticamente susceptibles. Se caracteriza por la combinación de diferentes manifestaciones clínicas dependientes del gluten con distintos grados de enteropatía, pudiendo ser desde una infiltración linfocítica del epitelio hasta atrofia de las vellosidades de la mucosa intestinal, presencia de anticuerpos específicos y haplotipos HLA-DQ2 y/o DQ8. El objetivo principal de este estudio consiste en el cribado de enfermedad celíaca en niños de 2 años donde se intentará lograr un diagnóstico precoz y así evitar todas las complicaciones que supone un diagnóstico tardío. Además, se pretende conocer el estado de la enfermedad celiaca en nuestra población pediátrica, prevalencia, haplotipos de riesgo y asociación de otras patologías, por lo que este estudio consiste en un análisis descriptivo, observacional y retrospectivo. Para ello se invitó a participar a 5455 niños de los cuales asistieron 1408 niños (25,81%). Este cribado ha consistido en determinar los anticuerpos antitransglutaminasa tisular 2 IgA o IgG (anti-tTG) junto a IgA total. Y posteriormente, se incorporó la prueba de anticuerpos anti-gliadina deaminada IgG (anti-DGPG), aportando una mayor rentabilidad diagnóstica. Observamos que la positividad de los anticuerpos anti-tTGA y anti-DGPG a la vez, predice el diagnóstico de EC. El cribado más adecuado para la población pediátrica es el cribado masivo. Y además, deben hacerse análisis periódicos. Y por último, el diagnóstico precoz de la enfermedad celíaca permite modificar los hábitos alimenticios y obtener beneficios para pacientes asintomáticos reduciendo la mortalidad y la morbilidad a largo plazo.
Palabras clave: Enfermedad celíaca, anti-transglutaminasa tisular 2, anti-gliadina deaminada
[EN]Celiac disease (CD) is a systemic disorder mediated by the immune system in genetically susceptible individuals. It is characterized by the combination of different gluten-dependent clinical manifestations with varying degrees of enteropathy, which can range from lymphocytic infiltration of the epithelium to atrophy of the villi of the intestinal mucosa, presence of specific antibodies and HLA-DQ2 and / or DQ8 haplotypes. The main objective of this study is the screening of celiac disease in 2-year-old children where an early diagnosis will be attempted and thus avoid all the complications involved in a late diagnosis. In addition, it is intended to know the status of celiac disease in our pediatric population, prevalence, risk haplotypes and association of other pathologies, so this study consists of a descriptive, observational and retrospective analysis. For this, 5455 children were invited to participate, 1408 children attended (25.81%). This screening has consisted in determining the antibodies to tissue anti-transglutaminase 2 IgA or IgG (anti-tTG) together with total IgA. And subsequently, the anti-gliadin deaminated IgG (anti-DGPG) antibody test was incorporated, providing greater Página | 10 diagnostic profitability. We note that the positivity of anti-tTGA and anti-DGPG antibodies at the same time predicts the diagnosis of CD. The most appropriate screening for the pediatric population is mass screening. And in addition, periodic analyzes should be done. And finally, the early diagnosis of celiac disease allows modifying eating habits and obtaining benefits for asymptomatic patients by reducing mortality and long-term morbidity. Keywords: Celiac disease, tissue anti-transglutaminase 2, deaminated anti-gliadin
[EN]Celiac disease (CD) is a systemic disorder mediated by the immune system in genetically susceptible individuals. It is characterized by the combination of different gluten-dependent clinical manifestations with varying degrees of enteropathy, which can range from lymphocytic infiltration of the epithelium to atrophy of the villi of the intestinal mucosa, presence of specific antibodies and HLA-DQ2 and / or DQ8 haplotypes. The main objective of this study is the screening of celiac disease in 2-year-old children where an early diagnosis will be attempted and thus avoid all the complications involved in a late diagnosis. In addition, it is intended to know the status of celiac disease in our pediatric population, prevalence, risk haplotypes and association of other pathologies, so this study consists of a descriptive, observational and retrospective analysis. For this, 5455 children were invited to participate, 1408 children attended (25.81%). This screening has consisted in determining the antibodies to tissue anti-transglutaminase 2 IgA or IgG (anti-tTG) together with total IgA. And subsequently, the anti-gliadin deaminated IgG (anti-DGPG) antibody test was incorporated, providing greater Página | 10 diagnostic profitability. We note that the positivity of anti-tTGA and anti-DGPG antibodies at the same time predicts the diagnosis of CD. The most appropriate screening for the pediatric population is mass screening. And in addition, periodic analyzes should be done. And finally, the early diagnosis of celiac disease allows modifying eating habits and obtaining benefits for asymptomatic patients by reducing mortality and long-term morbidity. Keywords: Celiac disease, tissue anti-transglutaminase 2, deaminated anti-gliadin